癫痫与主要合并症及并发症:医院教学状况与预后的关系

Aparna Yarram, A. Seifi, V. Eslami
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摘要

背景:本研究旨在比较教学机构与非教学医院复杂癫痫病例的预后。方法:利用医疗成本和利用项目(HCUP)国家数据库进行回顾性队列研究,分析2012年至2016年美国癫痫发作的结果。结果:我们评估了2012年至2016年间267430例癫痫患者的主要并发症或合并症。其中,据报告有6,980人在医院死亡。教学医院死亡率明显高于非教学医院(P = 0.07)。教学医院的平均住院时间(LOS)为5.2天,2014年和2016年的平均住院时间(LOS)更长(P < 0.05)。两组医院收费差异无统计学意义,但两类医院在2012 - 2016年的收费增长均有统计学意义(P < 0.001)。结论:我们的数据显示,教学医院的死亡率有明显升高的趋势。教学医院也报告了更多的LOS,这可能是教学医院的护理数量和协调增加以及病例更加复杂所固有的。而教学医院与非教学医院的收费差异不大。中华神经科学杂志,2020;10(4):127-131 doi: https://doi.org/10.14740/jnr588
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Seizures With Major Comorbidity and Complications: Association of the Teaching Status of the Hospitals With the Outcomes
Background: This study aims to compare the outcomes of complicated seizure cases in teaching institutions as compared to non-teaching hospitals. Methods: A retrospective cohort study was conducted utilizing the Healthcare Cost and Utilization Project (HCUP) national database to analyze outcomes of seizures between 2012 and 2016 in the USA. Results: We evaluated 267,430 of seizure patients with major complication or comorbidity between 2012 and 2016. Of these, 6,980 in-hospital deaths were reported. There was a trend toward a significantly higher mortality in teaching compared with non-teaching hospitals (P = 0.07). The average length of stay (LOS) was 5.2 days, with LOS in 2014 and 2016, being longer in teaching hospitals (P < 0.05). Hospital charges were not significantly different among the two groups, but both types of hospitals did show a statistically significant charge increase from 2012 to 2016 (P < 0.001). Conclusions: Our data showed that there is a trend toward significantly higher mortality in teaching hospitals. LOS was also more reported in teaching hospitals, which could be inherent to the increased volume and coordination of care and more complexity of the cases in teaching hospitals. However, hospital charges were not different in teaching versus non-teaching hospitals. J Neurol Res. 2020;10(4):127-131 doi: https://doi.org/10.14740/jnr588
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