在严重创伤性脑损伤的情况下,停止维持生命的治疗
Journal of neurosurgery
|September 12, 2025
概括
在严重创伤性脑损伤 (sTBI) 患者中,终止维持生命治疗 (WLST) 受到年龄,种族和保险的影响. 老年,医疗保险和透性伤害增加了WLST的几率,而黑人和西班牙裔患者的几率较低.
科学领域:
- 神经科学是一个神经科学.
- 创伤外科 手术 创伤外科
- 公共卫生 公共卫生
背景情况:
- 在严重创伤性脑损伤 (sTBI) 中,了解影响终止维持生命治疗 (WLST) 的因素对于改善患者护理至关重要.
- 关于WLST的决定是复杂的,受到许多患者和受伤相关因素的影响.
研究的目的:
- 确定与在sTBI患者中决定WLST相关的人口和临床因素.
- 为了比较患有和没有WLST的患者之间的结果.
主要方法:
- 使用2016-2022年美国外科医生学院创伤质量计划数据库进行回顾性队列研究.
- 多变量后勤回归分析以确定与WLST相关的因素.
- 医院住院时间,ICU住院时间,呼吸机日和处置结果的比较.
主要成果:
- 在202,160名sTBI患者中,21.9%的患者接受了WLST.
- 增加的年龄,医疗保险和透性伤害与较高的WLST的几率有关.
- 黑人和西班牙裔患者,以及格拉斯哥昏迷量表得分较高的患者,患WLST的几率较低.
结论:
- 患者的年龄,种族和保险状况是STBI患者WLST决定的重要因素.
- 需要进一步的研究来全面了解这些因素.
- 改善患者的结果和跨越社会经济差距的护理公平是关键目标.
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