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[德国中风后住院时间的影响因素]

[Factors influencing duration of hospitalization after stroke in Germany].

作者信息

Heuschmann P U, Kolominsky-Rabas P L, Misselwitz B, Hermanek P, Leffmann C, Von Reutern G M, Lachenmayer L, Bücker-Nott H J, Berger K

机构信息

Institut für Epidemiologie und Sozialmedizin, Universität Münster.

出版信息

Dtsch Med Wochenschr. 2004 Feb 13;129(7):299-304. doi: 10.1055/s-2004-818624.

Abstract

BACKGROUND

In Germany up-to-date data within community settings about factors influencing length of stay in acute hospitals are lacking. We, therefore, identified predictors for length of stay in acute hospital after ischemic stroke in a pooled analysis of large German stroke registers.

METHODS

Ischemic stroke patients admitted to hospitals cooperating within the German Stroke Registers Study Group (ADSR) between January 1, 2000 and December 31, 2000 were analysed. The influence of patients' demographic and clinical characteristics as well as the characteristics of the treating hospitals on length of stay were analysed by multivariate linear regression.

RESULTS

Overall, 13 440 patients after ischemic stroke were included in the analyses. Their mean age was 70 years, 53 % were men. Median length of stay in acute hospitals was 12 days. In multivariate analyses younger age, an increasing number of co-morbidities, and an increasing number of neurological deficits were identified as predictors of prolonged stay in hospital. Patients were more likely to stay longer in an acute hospital if they were to be discharged to a rehabilitation unit or to a nursing home. Length of stay was independently decreased for patients treated in hospitals providing acute stroke unit services and for hospitals treating more than 250 stroke patients per year.

CONCLUSION

In addition to patients' demographic and clinical characteristics, length of stay in hospital was influenced by the hospitals' characteristics. Especially the volume of treated patients and the organisation of services within the hospital may play the key role.

摘要

背景

在德国,社区环境中缺乏关于影响急性医院住院时间的因素的最新数据。因此,我们在对大型德国卒中登记处的汇总分析中确定了缺血性卒中后急性医院住院时间的预测因素。

方法

对2000年1月1日至2000年12月31日期间在德国卒中登记研究组(ADSR)内合作的医院收治的缺血性卒中患者进行分析。通过多变量线性回归分析患者的人口统计学和临床特征以及治疗医院的特征对住院时间的影响。

结果

总体而言,13440例缺血性卒中患者纳入分析。他们的平均年龄为70岁,53%为男性。急性医院的中位住院时间为12天。在多变量分析中,年龄较小、合并症数量增加和神经功能缺损数量增加被确定为住院时间延长的预测因素。如果患者出院后前往康复机构或疗养院,他们更有可能在急性医院停留更长时间。在提供急性卒中单元服务的医院接受治疗的患者以及每年治疗超过250例卒中患者的医院中,住院时间独立缩短。

结论

除了患者的人口统计学和临床特征外,住院时间还受医院特征的影响。特别是治疗患者的数量和医院内的服务组织可能起关键作用。

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