Haque Sameen, Crawley Karen, Davis Ryan, Schofield Deborah, Shrestha Rupendra, Sue Carolyn M
Neurology, Nepean Hospital, Kingswood, New South Wales, Australia.
Neurogenetics, Kolling Institute of Medical Research, St Leonards, New South Wales, Australia.
BMJ Neurol Open. 2024 Jun 11;6(1):e000717. doi: 10.1136/bmjno-2024-000717. eCollection 2024.
Mitochondrial diseases in adults are generally chronic conditions with a wide spectrum of severity contributing to disease burden and healthcare resource utilisation. Data on healthcare resource utilisation in mitochondrial diseases are limited.
We performed a retrospective longitudinal study to investigate the clinical drivers of hospitalisation in adult patients with mitochondrial diseases to better understand healthcare resource utilisation.
We recruited participants from our specialised Mitochondrial Disease Clinic in Sydney, Australia between September 2018 and December 2021. We performed a retrospective chart review for the period 2013-2022 considering emergency department (ED) and/or hospital admission notes, as well as discharge summaries. We used multiple linear regression models to examine the association between the type of presenting symptom(s) and duration of hospital stay and frequency of admissions, while adjusting for relevant covariates.
Of the 99 patients considered, the duration of hospitalisation ranged from 0 to 116 days per participant and the number of admissions ranged from 0 to 21 per participant. Participants with one or more mitochondrial disease-associated admissions constituted 52% of the study cohort. 13% of the participants presented to the ED without requiring an admission and 35% never attended the ED or required a hospital admission during this period. Neurological (p0.0001), gastroenterological (p=0.01) and symptoms categorised as 'other' (p0.0001) were the main presentations driving the total number of days admitted to hospital. A statistically significant association was evident for the number of admissions and all types of presenting symptoms (p0.0001).
There are variable reasons for hospitalisation in adults with mitochondrial diseases, with neurological and gastroenterological presentations being associated with prolonged and complex hospitalisation. A better understanding of clinical drivers such as these allows for better informed and well-coordinated management aimed at optimising healthcare resource utilisation.
成人线粒体疾病通常为慢性疾病，严重程度不一，导致疾病负担和医疗资源利用问题。线粒体疾病医疗资源利用的数据有限。
我们进行了一项回顾性纵向研究，以调查成年线粒体疾病患者住院的临床驱动因素，以便更好地了解医疗资源利用情况。
我们于2018年9月至2021年12月期间，从澳大利亚悉尼的专业线粒体疾病诊所招募参与者。我们对2013 - 2022年期间进行了回顾性病历审查，考虑了急诊科（ED）和/或住院记录以及出院小结。我们使用多元线性回归模型来检查出现症状的类型与住院时间和入院频率之间的关联，同时对相关协变量进行调整。
在纳入的99名患者中，每位参与者的住院时间为0至116天，入院次数为0至21次。有一次或多次与线粒体疾病相关入院的参与者占研究队列的52%。13%的参与者前往急诊科但无需住院，35%的参与者在此期间从未去过急诊科或需要住院治疗。神经科（p<0.0001）、胃肠科（p = 0.01）以及归类为“其他”的症状（p<0.0001）是导致住院总天数的主要症状表现。入院次数与所有类型的症状表现之间存在统计学上的显著关联（p<0.0001）。
成年线粒体疾病患者住院的原因各不相同，神经科和胃肠科症状表现与长期、复杂的住院治疗相关。更好地了解此类临床驱动因素有助于进行更明智、协调良好的管理，以优化医疗资源利用。
