Lee Se Won, Thantacheva Thanapath D, Mack Denny
Sunrise Health GME Consortium, MountainView Hospital, Las Vegas, NV.
Southern Nevada VA Healthcare System, Las Vegas, NV.
HCA Healthc J Med. 2024 Aug 1;5(4):435-443. doi: 10.36518/2689-0216.1698. eCollection 2024.
Our main objective was to compare the characteristics and hospital outcomes of patients with primary and metastatic brain malignancies and to investigate the associated factors related to hospital outcomes.
We conducted a retrospective, cross-sectional study of 1628 patients with brain malignancies from 8 community hospitals between 2017 and 2022 who were identified using International Classification of Disease codes. A stepwise logistic regression was used to identify demographics and clinical characteristics associated with in-hospital mortality and home discharge.
The median age was 65 years old, with 72.5% of patients having metastatic brain malignancies. After 7.2 days of hospital stay, 49.2% were discharged home, and 102 patients expired during hospitalization. Increased age, medical coverage by Medicare, hemiplegia or paraplegia, lower initial hemoglobin level, increased length of stay, and the use of electrolyte replacement, antibiotics, laxatives, heparin, and anticonvulsants were associated with a decreased likelihood of discharge to home. No medical insurance, Medicaid insurance coverage, comorbidities of cerebrovascular disorder, the need to stay in the intensive care unit, patient safety indicator events, and the use of antibiotics, oral analgesics, and ipratropium-albuterol were associated with increased odds of in-hospital mortality.
We identified several predictor variables that delineate differences between both mortality risk and home discharge in patients with primary and metastatic brain tumors. Understanding these predictor variables can be helpful in improving the acute and post-acute care of this population.
我们的主要目标是比较原发性和转移性脑恶性肿瘤患者的特征及住院结局,并调查与住院结局相关的因素。
我们对2017年至2022年间8家社区医院的1628例脑恶性肿瘤患者进行了一项回顾性横断面研究,这些患者是使用国际疾病分类代码识别出来的。采用逐步逻辑回归分析来确定与院内死亡率和出院回家相关的人口统计学和临床特征。
中位年龄为65岁,72.5%的患者患有转移性脑恶性肿瘤。住院7.2天后,49.2%的患者出院回家,102例患者在住院期间死亡。年龄增加、医疗保险覆盖、偏瘫或截瘫、初始血红蛋白水平较低、住院时间延长以及使用电解质补充剂、抗生素、泻药、肝素和抗惊厥药与出院回家的可能性降低相关。没有医疗保险、医疗补助保险覆盖、脑血管疾病合并症、需要入住重症监护病房、患者安全指标事件以及使用抗生素、口服镇痛药和异丙托溴铵-沙丁胺醇与院内死亡几率增加相关。
我们确定了几个预测变量,这些变量描绘了原发性和转移性脑肿瘤患者在死亡风险和出院回家方面的差异。了解这些预测变量有助于改善该人群的急性和急性后护理。