患者的死亡率:一个系统性审查
Xinwei Xu1,2, Leihao Sha1,2, Sijia Basang1,2
1Department of Neurology, West China Hospital, Sichuan University, No. 28 Dianxin South street, Chengdu, 610041, Sichuan, China.
Journal of neurology
|March 26, 2025
概括
的死亡率在全球范围内正在下降,但在高收入国家,特别是老年人中,死亡率正在上升. 的突然意外死亡 (SUDEP) 仍然是一个主要问题,需要有针对性的预防策略.
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:
- 与显著增加的死亡风险有关,但公众对这种风险的认识显著低.
- 了解死亡率模式对于制定有效的预防策略和减少过早死亡至关重要.
研究的目的:
- 系统地调查相关死亡率的特征.
- 为了确定趋势,区域差异,以及患者过早死亡的经济影响.
- 审查中突然意外死亡 (SUDEP) 的干预策略和建议.
主要方法:
- 对PubMed和Embase数据库的系统文献审查,截至2024年6月.
- 使用纽卡斯尔-太华尺度进行质量评估,并分析死亡率趋势,区域差异和经济影响.
- 包括全球疾病负担 (GBD) 数据用于趋势验证和SUDEP指南的审查.
主要成果:
- 死亡率在全球范围内呈现下降趋势,低收入国家有所改善,与高收入地区的上升趋势形成对比.
- 老年人,特别是那些患有心血管疾病和肺炎等并发症的人,在老龄化高收入地区,占相关死亡人数的比例越来越高.
- 在男性中观察到更高的死亡率,在诊断后的早期,在长期不受控制的的情况下,SUDEP仍然是死亡的主要原因. 在低收入地区,事故和自杀更频繁.
结论:
- 性别,地理区域和持续时间显著影响死亡率结果.
- 未来的研究应该优先考虑了解老年患者的死亡率特征,并为SUDEP开发个性化干预措施.
相关概念视频
01:24Arteries of the Lower Limbs
174
Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
174
01:13Seizures: Classification
293
Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
293
01:14Antiepileptic Drugs: Glutamate Antagonists
264
Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
264
01:24Kaplan-Meier Approach
67
The Kaplan-Meier estimator is a non-parametric method used to estimate the survival function from time-to-event data. In medical research, it is frequently employed to measure the proportion of patients surviving for a certain period after treatment. This estimator is fundamental in analyzing time-to-event data, making it indispensable in clinical trials, epidemiological studies, and reliability engineering. By estimating survival probabilities, researchers can evaluate treatment effectiveness,...
67
01:30Electroconvulsive Therapy
20
Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
20