确认神经传染病诊断的时间:诊断测试和资源分配
Rachelle Dugue1,2, Carla Kim1, Abhilasha Boruah1,3
1Department of Neurology, Columbia University Irving Medical Center/New York Presbyterian Hospital (CUIMC/NYP), New York, NY, USA.
The Neurohospitalist
|June 19, 2024
概括
高效地诊断神经系统感染至关重要. 病毒性神经感染在较少的测试中被诊断得更快,与免疫抑制患者需要更长时间住院的病例不同.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 诊断医学 诊断医学
背景情况:
- 神经感染带来了显著的发病率和死亡率风险.
- 有效的诊断对于及时和适当的患者管理至关重要.
- 三级转诊中心在管理复杂的神经感染病例方面发挥着关键作用.
研究的目的:
- 评估对终极神经感染的诊断方法.
- 评估诊断的时间,订购的测试数量和诊断方式.
- 确定影响诊断效率和患者治疗结果的因素.
主要方法:
- 对111例确诊的神经感染病例 (2010-2018年) 的回顾性审查.
- 最终的诊断标准包括阳性脑脊液 (CSF) PCR/抗原,CSF培养物,CSF抗体,血清学或病理学.
- 分析诊断的时间,订购的测试,以及ICU入院和住院时间等患者因素.
主要成果:
- 病因诊断的平均时间为3.1天,每次检查有27.7次检查.
- 病毒性神经感染的诊断时间更短,检测更少,住院时间更短 (P < .05).
- 免疫抑制与不论感染类型 (P < .001) 住院时间较长有关.
结论:
- 优化神经感染的诊断策略是必不可少的.
- 了解病因差异,比如病毒与其他病原体之间的差异,可以提高效率.
- 患者因素,如免疫抑制状态,显著影响临床过程和资源利用.
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