在怀疑中枢神经系统感染的成年人中,不利结果的预测因素:前性队列研究
Liora Ter Horst1, Ingeborg E van Zeggeren1, Sabine E Olie1
1Amsterdam UMC, Department of Neurology, Amsterdam Neuroscience, University of Amsterdam, Meibergdreef 9, PO Box 22660, 1105 AZ, Amsterdam, The Netherlands.
Scientific reports
|December 1, 2023
概括
预测疑似中枢神经系统 (CNS) 感染的不良结果至关重要. 中枢神经系统炎症疾病和特定的临床症状是不利结果的关键预测因素.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 中枢神经系统 (CNS) 感染带来了诊断挑战,特别是在重症患者中.
- 识别不良结果的预测因素对于优先诊断和改善治疗策略至关重要.
- 不利的结果显著影响患者的预后和医疗保健资源分配.
研究的目的:
- 在疑似中枢神经系统 (CNS) 感染的患者中确定不利结果的预测因素.
- 在疑似中枢神经系统感染病例中分层风险,以指导诊断和治疗干预.
- 突出了对中枢神经系统感染的快速和准确诊断工具的需求.
主要方法:
- 分析了来自荷兰两个可疑中枢神经系统感染的潜在队列的1152次发作.
- 在医院出院时使用格拉斯哥结果表评估不良结果 (得分1-4).
- 统计分析以确定不利结果的预测因素,包括人口,临床和实验室变量.
主要成果:
- 36%的患者 (412/1152) 经历了不利的结果,死亡率为9% (99/1152).
- 不良结局的关键预测因素包括晚年,没有头痛,心动减速,精神状态变化,脑焦点缺陷,神经,血栓细胞低,脑脊液 (CSF) 蛋白质高.
- 中枢神经系统 (CNS) 炎症性疾病与不利结果的最高风险相关 (几率比率4.5 [95%置信区间1.5-12.6]).
结论:
- 疑似中枢神经系统感染带有不良结果的高风险,强调需要快速和准确的诊断.
- 中枢神经系统 (CNS) 炎症性疾病在疑似中枢神经系统感染中代表一个特别高风险的亚组.
- 预测因素的早期识别可以促进及时干预,并改善疑似中枢神经系统感染患者的患者管理.
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