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癫痫持续状态中的周末效应:一项全国队列研究。

The weekend effect in status epilepticus: a national cohort study.

机构信息

Department of Critical Care medicine, University Hospital of Birmingham NHS trust, Birmingham, UK.

Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.

出版信息

Anaesthesia. 2019 Apr;74(4):468-472. doi: 10.1111/anae.14571. Epub 2019 Jan 3.

Abstract

Higher mortality following admission to hospital at the weekend has been reported for several conditions. It is unclear whether this variation is due to differences in patients or their care. Status epilepticus mandates hospital admission and usually critical care: its study might provide new insights into the nature of any weekend effect. We studied 20,922 adults admitted to UK critical care with status epilepticus from 2010 to 2015. We used multiple logistic regression to evaluate the association between weekend admission and in-hospital mortality, comparing university hospitals with other hospitals. There were 2462 in-hospital deaths (12%). There was no difference in mortality after weekend admission to university hospitals, adjusted odds ratio (95%CI) 0.99 (0.84-1.16), p = 0.89. Mortality was less after weekend admission than after admissions Monday to Friday in hospitals not associated with a university, adjusted odds ratio (95%CI) 0.74 (0.64-0.87), p = 0.0001. There is no evidence that adults admitted to UK critical care at the weekend in status epilepticus are more likely to die than similar patients admitted during the week.

摘要

已有多项研究报告称,某些疾病患者在周末住院后的死亡率更高。目前尚不清楚这种差异是由于患者本身的差异还是治疗差异导致的。癫痫持续状态需要住院治疗且通常需要重症监护,对其进行研究可能有助于深入了解周末效应的本质。我们对 2010 年至 2015 年期间在英国重症监护病房因癫痫持续状态入院的 20922 名成年人进行了研究。我们使用多因素逻辑回归分析评估了周末入院与院内死亡率之间的关联,并比较了大学医院和其他医院。共有 2462 例院内死亡(12%)。大学医院周末入院与院内死亡率之间无差异,调整后比值比(95%可信区间)为 0.99(0.84-1.16),p=0.89。与大学没有关联的医院,周末入院的死亡率低于周一至周五入院,调整后比值比(95%可信区间)为 0.74(0.64-0.87),p=0.0001。这些结果表明,在英国,因癫痫持续状态而在周末入住重症监护病房的成年人与在一周内其他时间入住的类似患者相比,死亡风险并没有增加。

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