美国多中心医疗保健系统中的深度大脑刺激 - 从2010年到2021年的描述性流行病学综述
Mark F Sedrak1, Richard N Chang2, Patrick Pezeshkian1
1Department of Neurosurgery and Neuroscience, The Permanente Medical Group, Redwood City, CA, United States.
概括
深度大脑刺激 (DBS) 结果分析了超过1000名患者在12年的时间里. 虽然植入技术各不相同,但可充电系统的使用量增加,需要进一步研究以减少并发症.
科学领域:
- 神经外科 神经外科
- 神经学 神经学
- 医疗技术 医疗技术 医学技术
背景情况:
- 深度大脑刺激 (DBS) 正在发展,需要了解社区环境中的实践变化和结果.
- 本研究检查了12年的DBS患者队列在一个大型的,综合的美国医疗保健系统.
研究的目的:
- 描述DBS安置后的患者特征和结果.
- 分析十年来DBS植入的实践变化和趋势.
主要方法:
- 电子健康记录识别了1,158名接受初始DBS安置 (2010-2021) 的患者.
- 卡普兰-梅尔方法估计了植入式脉冲发生器 (IPG) 替换,重新操作和死亡率的累积概率.
- 计算了90天急诊室 (ED) 访问和再接收的发生率.
主要成果:
- 在769名患者中植入了双边系统,在389名患者中植入了单边系统.
- 90天的结果包括14.3%的ED访问,8.5%的再入院和1.2%的感染.
- 3年后,14.5%需要IPG替换,18.1%接受了重新手术;5年死亡率为9.3%.
结论:
- 在研究期间观察到DBS植入的实践变化.
- 随着时间的推移,可充电DBS系统的使用量有所增加.
- 需要进行进一步的研究,以确定可修改的风险因素,以确定诸如再入院和再手术等不良结果.
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