新型冠状病毒2型感染对神经重症监护病房住院时间的影响：2023年2月至4月在中国8个神经重症监护病房进行的一项前瞻性多中心队列研究

The Impact of SARS-CoV-2 Infection on the Length of Stay in the Neuro-ICU:A Prospective Multicenter Cohort Study in Eight Neuro-ICU, China Between February and April 2023.

作者信息

Tan Liang, Wang Feilong, Huang Yi, Fu Chuhua, Zhang Haijun, Feng Jianfei, Xu Yincai, Ye Xinzhen, Tang Rongrui, Chen Yinglian, Mou Liansheng, Li Ronghao, Chen Jingyu, Xian Jishu

机构信息

Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, People's Republic of China.

Department of Neurosurgery, The Ninth People's Hospital of Chongqing, Chongqing, People's Republic of China.

出版信息

Neuropsychiatr Dis Treat. 2024 Mar 30;20:765-775. doi: 10.2147/NDT.S447887. eCollection 2024.

DOI:10.2147/NDT.S447887

PMID:38577632

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10992672/

Abstract

PURPOSE

The SARS-CoV-2 infection cases are increasing rapidly in neuro-intensive care units (neuro-ICUs) at the beginning of 2023 in China. We aimed to characterize the prevalence, risk factors, and prognosis of critically ill patients treated in neuro-ICUs.

MATERIALS AND METHODS

In the prospective, multicenter, observational registry study, critically ill patients with intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), and traumatic brain injury (TBI) admitted to eight Chinese neuro-ICUs between Feb 16, 2023, to Apr 30, 2023 were enrolled for the study. Mortality and ICU stay day were used as the primary outcomes.

RESULTS

131 patients were finally included and analyzed (mean age 60.36 years [SD 13.81], 64.12% male, 39.69% SARS-CoV-2 infected). The mortality is higher in the SARS-CoV-2 infection group without statistical signification (7.69% vs 5.06%, p>0.05). The length of stay (LOS) in neuro-ICUs was significantly longer among the SARS-CoV-2 infection patients (7(1-12) vs 4(1-8), p<0.01), with increased viral pneumonia occurrence (58.54% vs 7.32%, p<0.01). SARS-CoV-2 infection, surgery, and low GCS scores were independent risk factors for prolonged LOS, and respiratory/renal failure were independent risk factors for death.

CONCLUSION

Based on the present neuro-ICU cohort, SARS-CoV-2 infection was a significant risk for the prolonged LOS of neuro-critically ill patients.

TRIAL REGISTRATION

Registered with Chictr.org.cn (ChiCTR2300068355) at 16 February 2023, Prospective registration. https://www.chictr.org.cn/showproj.html?proj=188252.

摘要

目的

2023年初，中国神经重症监护病房（神经ICU）的新型冠状病毒2型（SARS-CoV-2）感染病例迅速增加。我们旨在描述在神经ICU接受治疗的重症患者的患病率、危险因素和预后情况。

材料与方法

在这项前瞻性、多中心、观察性登记研究中，纳入了2023年2月16日至2023年4月30日期间在中国8家神经ICU收治的脑出血（ICH）、蛛网膜下腔出血（SAH）和创伤性脑损伤（TBI）的重症患者进行研究。将死亡率和ICU住院天数作为主要结局指标。

结果

最终纳入并分析了131例患者（平均年龄60.36岁[标准差13.81]，男性占64.12%，SARS-CoV-2感染患者占39.69%）。SARS-CoV-2感染组的死亡率较高，但无统计学意义（7.69%对5.06%，p>0.05）。SARS-CoV-2感染患者在神经ICU的住院时间显著更长（7（1 - 12）天对4（1 - 8）天，p<0.01），且病毒性肺炎的发生率更高（58.54%对7.32%，p<0.01）。SARS-CoV-2感染、手术和低格拉斯哥昏迷量表（GCS）评分是住院时间延长的独立危险因素，呼吸/肾衰竭是死亡的独立危险因素。