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2000 年至 2008 年神经重症监护病房的流行病学趋势。

Epidemiological trends in the neurological intensive care unit from 2000 to 2008.

机构信息

Cerebrovascular Laboratory, Department of Neurological Surgery, Columbia University, College of Physicians and Surgeons, 630 West 168 Street Room 5-454, New York, NY 10032, USA.

出版信息

J Clin Neurosci. 2012 Dec;19(12):1668-72. doi: 10.1016/j.jocn.2012.04.011. Epub 2012 Oct 11.

Abstract

Intensive care units (ICU) specializing in the treatment of patients with neurological diseases (Neuro-ICU) have become increasingly common. However, there are few data on the longitudinal demographics of this patient population. Identifying admission trends may provide targets for improving resource utilization. We performed a retrospective analysis of admission logs for primary diagnosis, age, sex, and length of stay, for all patients admitted to the Neuro-ICU at Columbia University Medical Center (CUMC) between 2000 and 2008. From 2000 to 2008, inclusive, the total number of Neuro-ICU admissions increased by 49.9%. Overall mean patient age (54.6 ± 17.4 to 56.2 ± 18.0 years, p=0.041) and gender (55.9-50.3% female, p=0.005) changed significantly, while median length of stay (2 days) did not. When comparing the time period prior to construction of a larger Neuro-ICU (2000-2004) to that after completion (2005-2008), patient age (56.0 ± 17.6 compared to 56.9 ± 17.5 years, p=0.012) and median length of stay (1 compared to 2 days, p<0.001) both significantly increased. Construction of a newer, larger Neuro-ICU at CUMC led to a substantial increase in admissions and changes in diagnoses from 2000 to 2008. Advances in neurocritical care, neurosurgical practices, and the local and global expansion and utilization of ICU resources likely led to differences in lengths of stay.

摘要

重症加强治疗病房(ICU)专门治疗神经疾病患者(神经重症监护病房)已经越来越普遍。然而,关于该患者群体的纵向人口统计学数据很少。确定入院趋势可能为改善资源利用提供目标。我们对 2000 年至 2008 年间哥伦比亚大学医学中心(CUMC)神经重症监护病房所有患者的入院记录进行了回顾性分析,分析的内容包括主要诊断、年龄、性别和住院时间。2000 年至 2008 年期间,神经重症监护病房的入院人数增加了 49.9%。总体而言,患者的平均年龄(54.6±17.4 岁至 56.2±18.0 岁,p=0.041)和性别(女性比例从 55.9%至 50.3%,p=0.005)发生了显著变化,而中位住院时间(2 天)没有变化。与神经重症监护病房扩建前(2000-2004 年)相比,扩建后(2005-2008 年)的患者年龄(56.0±17.6 岁与 56.9±17.5 岁,p=0.012)和中位住院时间(1 天与 2 天,p<0.001)均显著增加。CUMC 建造了一个更新、更大的神经重症监护病房,导致 2000 年至 2008 年期间入院人数和诊断发生了重大变化。神经危重病护理、神经外科实践的进步,以及 ICU 资源在当地和全球的扩展和利用,可能导致住院时间的差异。

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