在诊断和转诊后,功能性发作患者的死亡率增加
Wesley T Kerr1, Elissa H Patterson1, Isabel M O'Sullivan1
1Departments of Neurology and Biomedical Informatics (WTK), University of Pittsburgh, PA; Department of Neurology (WTK, EHP, IMO, FJH, KAD, PSP, NR-M, GSW, NJB); Department of Psychiatry (EHP, GSW, NJB), University of Michigan, Ann Arbor; Department of Neurology (KAD), St. Elizabeth Medical Center, Fort Thomas; Department of Neurology (KAD), Hazard Appalachian Regional Health, Hazard, KY; Department of Neurology (PSP), John F. Kennedy University Medical Center, Edison; Departments of Neurology and Psychiatry (PSP), Hackensack Meridian School of Medicine, Nutley, NJ; Department of Social Work (NR-M); and Department of Surgery (GSW), University of Michigan, Ann Arbor, MI.
功能性发作的患者在诊断和治疗转诊后不久就死亡率高出2.4倍. 这项研究强调了在美国医疗保健系统中,这一患者群体的死亡风险较高.
科学领域:
- 神经学 神经学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 功能性 (FS) 是一种神经事件,不是由引起的.
- 患有FS的患者通常被转介到多学科诊所接受专业治疗.
- 关于与FS相关的死亡率的数据有限,特别是在美国的背景下.
研究的目的:
- 评估在美国被诊断患有功能性的患者中标准化死亡率 (SMR).
- 评估在多学科功能性发作诊所转诊治疗的个体的死亡风险.
主要方法:
- 从单一中心诊所登记处回顾电子健康记录的回顾性审查.
- 通过将观察到的死亡人数与年龄,性别和种族相匹配的人口中预期的死亡人数进行比较来计算SMR.
- 在1,329个患者年内对700名FS患者进行了随访.
主要成果:
- 观察到的SMR为2.4 (95% CI: 1.17-4.22),表明死亡风险增加了2.4倍.
- 死亡率为每1000个患者年中的8.2.
- 确定的死亡原因中没有一个直接与有关;五起死亡发生在临终关怀中.
结论:
- 数据表明,在诊断和治疗开始后不久,功能性发作患者的死亡率增加.
- 来自美国医疗保健系统的研究结果证实了有关FS.死亡率增加的国际研究.
- 需要进一步的研究,以了解导致这种高死亡率的因素.
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