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美国因水杨酸盐中毒住院患者的横纹肌溶解症:2003-2014 年全国住院患者样本。

Rhabdomyolysis among hospitalized patients for salicylate intoxication in the United States: Nationwide inpatient sample 2003-2014.

机构信息

Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand.

Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, United States of America.

出版信息

PLoS One. 2021 Mar 8;16(3):e0248242. doi: 10.1371/journal.pone.0248242. eCollection 2021.

Abstract

INTRODUCTION

This study aimed to assess the risk factors and impact of rhabdomyolysis on treatments, outcomes, and resource utilization in hospitalized patients for salicylate intoxication in the United States.

MATERIALS AND METHODS

The National Inpatient Sample was utilized to identify hospitalized patients with a primary diagnosis of salicylate intoxication from 2003-2014. Rhabdomyolysis was identified using hospital diagnosis code. We compared the clinical characteristics, in-hospital treatment, outcomes, and resource utilization between patients with and without rhabdomyolysis.

RESULTS

A total of 13,805 hospital admissions for salicylate intoxication were studied. Of these, rhabdomyolysis developed in 258 (1.9%) admissions. The risk factors for rhabdomyolysis were age>20 years, male sex, volume depletion, hypokalemia, sepsis, and seizure. After adjustment for baseline clinical characteristics, salicylate intoxication patients with rhabdomyolysis required more invasive mechanical ventilation, and renal replacement therapy. Rhabdomyolysis was significantly associated with higher risk of failure of any organ systems, and in-hospital mortality. Length of hospital stay and hospitalization cost were higher when rhabdomyolysis occurred during hospital stay.

CONCLUSIONS

Rhabdomyolysis was not common in hospitalized patients for salicylate intoxication but it was associated with increased morbidity, mortality, and resource utilization.

摘要

简介

本研究旨在评估在美国住院治疗的水杨酸盐中毒患者中横纹肌溶解症的风险因素及其对治疗、结局和资源利用的影响。

材料和方法

利用国家住院患者样本,于 2003 年至 2014 年间确定了患有原发性水杨酸盐中毒的住院患者。横纹肌溶解症通过医院诊断代码进行识别。我们比较了有和没有横纹肌溶解症的患者的临床特征、住院治疗、结局和资源利用。

结果

共研究了 13805 例因水杨酸盐中毒住院的患者。其中,258 例(1.9%)发生了横纹肌溶解症。横纹肌溶解症的风险因素包括年龄>20 岁、男性、容量不足、低钾血症、败血症和癫痫发作。在调整了基线临床特征后,患有横纹肌溶解症的水杨酸盐中毒患者需要更多的有创机械通气和肾脏替代治疗。横纹肌溶解症与任何器官系统衰竭和院内死亡率的风险增加显著相关。发生横纹肌溶解症时,住院时间和住院费用更高。

结论

在住院治疗的水杨酸盐中毒患者中,横纹肌溶解症并不常见,但它与更高的发病率、死亡率和资源利用有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a3f/7939294/5dbad71fb4b8/pone.0248242.g001.jpg

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