1991 - 1992年马里兰州神经系统疾病对与人类免疫缺陷病毒感染相关住院治疗的影响。

The impact of neurologic disease on hospitalizations related to human immunodeficiency virus infection in Maryland, 1991-1992.

作者信息

Dal Pan G J, Skolasky R L, Moore R D

机构信息

Department of Neurology, Johns Hopkins University, Baltimore, Md., USA.

出版信息

Arch Neurol. 1997 Jul;54(7):846-52. doi: 10.1001/archneur.1997.00550190036012.

DOI:10.1001/archneur.1997.00550190036012

PMID:9236573

Abstract

OBJECTIVES

To determine the impact of neurologic disease on length of stay and total hospital charges for hospitalizations related to human immunodeficiency virus (HIV) infection.

DESIGN

Review of all HIV-related hospitalizations from all acute nonfederal hospitals in Maryland in 1991 and 1992. Neurologic status and HIV disease status were determined by codes from the International Classification of Diseases, Ninth Revision Clinical Modification, in an administrative database. Total hospital charges and length of stay were also included in this database.

RESULTS

Of 12 128 HIV-related hospitalizations (6013 patients with the acquired immunodeficiency syndrome [AIDS], 308 HIV-seropositive patients with symptoms without AIDS, and 5807 HIV-seropositive patients without symptoms), neurologic disease occurred in 1013 (8.4%), predominantly in patients with AIDS. In all HIV-seropositive patients, those with primary neurologic disease had a long mean (+/- SD) length of stay (16.4 +/- 16.5 days vs 9.3 +/- 11.3 days; P < .001) and higher mean (+/- SD) total charges ($12,733 +/- $12,009 vs $8069 +/- $11,247; P < .001) than those without neurologic disease. In patients with AIDS, those with primary neurologic disease also had a longer mean (+/- SD) length of stay (17.2 +/- 17.2 days vs 11.7 +/- 12.7 days; P < .001) and higher mean (+/- SD) total charges ($13,430 +/- $12,470 vs $10,794 +/- $13,537; P < .001) than those without neurologic disease. After adjustment for age, sex, race, and stage of HIV infection in all HIV-seropositive patients, our results indicated that neurologic disease increased the length of stay by 3.3 days (95% confidence interval [CI], 2.9-3.8) and total charges by $2552 (95% CI, $2111-$2993). After adjustment for age, sex, and race in discharged patients with AIDS, the results showed that neurologic disease increased length of stay by 2.24 days (95% CI, 0.73-3.77) and total charges by $1512 (95% CI, $40-$2894).

CONCLUSION

Neurologic disease increases the length of stay and total hospital charges of HIV-infected patients.

摘要

目的

确定神经系统疾病对与人类免疫缺陷病毒（HIV）感染相关住院患者住院时间和总住院费用的影响。

设计

回顾1991年和1992年马里兰州所有急性非联邦医院的所有HIV相关住院病例。通过行政数据库中《国际疾病分类，第九版临床修订本》的编码确定神经系统状况和HIV疾病状况。该数据库还包括总住院费用和住院时间。

结果

在12128例HIV相关住院病例中（6013例获得性免疫缺陷综合征[艾滋病]患者、308例有症状但无艾滋病的HIV血清阳性患者和5807例无症状的HIV血清阳性患者），1013例（8.4%）发生神经系统疾病，主要见于艾滋病患者。在所有HIV血清阳性患者中，患有原发性神经系统疾病的患者平均住院时间（±标准差）较长（16.4±16.5天对9.3±11.3天；P<0.001），平均总费用（±标准差）较高（12733±12009美元对8069±11247美元；P<0.001）。在艾滋病患者中，患有原发性神经系统疾病的患者平均住院时间（±标准差）也较长（17.2±17.2天对11.7±12.7天；P<0.001），平均总费用（±标准差）较高（13430±12470美元对10794±13537美元；P<0.001）。在对所有HIV血清阳性患者的年龄、性别、种族和HIV感染阶段进行调整后，我们的结果表明，神经系统疾病使住院时间延长3.3天（95%置信区间[CI]，2.9 - 3.8），总费用增加2552美元（95%CI，2111 - 2993美元）。在对出院的艾滋病患者的年龄、性别和种族进行调整后，结果显示神经系统疾病使住院时间延长2.24天（95%CI，0.73 - 3.77），总费用增加1512美元（9%CI，40 - 2894美元）。