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原发性震颤患者住院和急诊就诊的原因。

Reasons for Hospitalizations and Emergency Department Visits Among Patients with Essential Tremor.

机构信息

Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA.

University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.

出版信息

Tremor Other Hyperkinet Mov (N Y). 2024 Sep 23;14:47. doi: 10.5334/tohm.934. eCollection 2024.

Abstract

BACKGROUND

Prior studies suggest that patients with essential tremor (ET) have increased rates of healthcare utilization, but the reason for this increased use is unknown. The objective of this study was to evaluate the reasons for healthcare use among ET patients.

METHODS

This was a retrospective cross-sectional study of ET patients with an admission or emergency department (ED) visit at a tertiary health system from 2018-2023. Patients were matched on an encounter level with control patients based on propensity scores incorporating age, sex, race, and co-morbid conditions. The primary outcome was the odds of an encounter for each diagnostic category comparing ET patients with matched controls.

RESULTS

Only inpatient admissions for neurologic diagnoses were more likely for ET compared to control patients (odds ratio (OR) 3.73, 95% confidence interval (CI) 2.54 - 5.49, p < 0.001). Once admissions related to the surgical treatment of tremor were excluded, admissions for neurologic diagnoses were equally likely among ET and control patients (OR 0.96, 95% CI 0.59 - 1.57, p = 0.88).

DISCUSSION

Surgical treatment of tremor appears to be a key driver of healthcare use among ET patients. Future investigations should examine the pattern of healthcare use of ET patients before and after surgery.

HIGHLIGHTS

Prior studies have shown increased healthcare use among essential tremor (ET) patients. The objective of this study was to evaluate the reasons for healthcare use among ET patients compared to matched control patients. Surgical treatment of tremor was found to be a key driver of healthcare use among ET patients.

摘要

背景

先前的研究表明,特发性震颤(ET)患者的医疗保健利用率较高,但原因尚不清楚。本研究的目的是评估 ET 患者医疗保健使用的原因。

方法

这是一项回顾性的横断面研究,纳入了 2018 年至 2023 年期间在一家三级医疗系统就诊的 ET 患者。根据包含年龄、性别、种族和合并症的倾向评分,对患者进行了匹配。主要结局是比较 ET 患者和匹配对照患者的每种诊断类别的就诊概率。

结果

仅神经科诊断的住院入院的可能性与对照患者相比,ET 患者更高(比值比(OR)3.73,95%置信区间(CI)2.54-5.49,p<0.001)。排除与震颤手术治疗相关的入院后,ET 患者和对照患者的神经科诊断入院率相当(OR 0.96,95%CI 0.59-1.57,p=0.88)。

讨论

震颤手术治疗似乎是 ET 患者医疗保健使用的主要驱动因素。未来的研究应该检查 ET 患者手术前后的医疗保健使用模式。

重点

先前的研究表明,特发性震颤(ET)患者的医疗保健利用率较高。本研究的目的是评估与匹配对照患者相比,ET 患者医疗保健使用的原因。震颤手术治疗是 ET 患者医疗保健使用的主要驱动因素。

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