急性脑损伤的流行病学模式和变化:韩国神经关键病房的多中心注册分析
Heewon Jeong1, So Hee Park2, Yoon-Hee Choo3
1Department of Neurosurgery, Chungnam National University Hospital, Daejeon, South Korea.
Neurocritical care
|July 22, 2025
概括
在韩国,对于急性脑损伤 (ABI) 患者,神经关键护理的变化存在. 然而,中心特定的实践并没有显著影响大多数临床结果,这表明患者因素是关键因素.
科学领域:
- 神经学 神经学
- 临界护理医学 临界护理医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 专门的神经临床护理 (NCC) 改善了急性脑损伤 (ABI) 的结果.
- 在韩国正在发展的国家NCC系统中,实践在很大程度上有所不同.
- 这项研究评估了韩国6个三级NCC单位 (NCCU) 的ABI患者护理的变化.
研究的目的:
- 评估韩国NCCU中ABI患者的临床变异性.
- 确定中心特异性影响对ABI患者临床结果的影响.
主要方法:
- 分析了1125名在2023年4月至2024年4月期间入院的ABI患者的多中心注册表.
- 描述性分析评估了人口,临床和治疗特征.
- 混合效应和固定效应模型评估了对功能结果 (mRS),死亡率,NCCU停留时间和气管切除率的中心特定影响.
主要成果:
- 在患者特征,严重程度和治疗实践 (例如,ICP监测,血管预防) 中发现了显著的变化 (SMD>0.2).
- 中心特异性影响没有显著影响6个月功能结果,住院死亡率,NCCU停留时间或气管切除率.
- 仅对12个月的mRS得分 (P=0.01) 观察到显著影响.
结论:
- 在韩国NCCU的ABI患者中存在显著的临床变异性.
- 特定中心的影响对关键的NCCU相关结果的影响最小.
- 结果的变化可能更多地受到患者层面的因素的影响,而不是中心特定的护理变化.
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