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首页> 外文期刊>Journal of Clinical Medicine Research >Temporal Trends of the Clinical, Resource Use and Outcome Attributes of ICU-Managed Candidemia Hospitalizations: A Population-Level Analysis
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Temporal Trends of the Clinical, Resource Use and Outcome Attributes of ICU-Managed Candidemia Hospitalizations: A Population-Level Analysis

机译：ICU管理的念珠菌血症住院治疗的临床，资源使用和结果属性的时间趋势：人群水平分析

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Background: There are mixed findings on the longitudinal patterns of the incidence of intensive care unit (ICU)-managed candidemia, with scarcity of reports on the corresponding evolving patterns of patients’ clinical characteristics and outcomes. No population-level data were reported on the temporal trends of the attributes, care and outcomes of ICU-managed adults with candidemia.Methods: The Texas Inpatient Public Use Data File was used to identify hospitalizations aged 18 years or older with a diagnosis of candidemia and ICU admission (C-ICU hospitalizations) between 2001 and 2010. Temporal trends of the demographics, clinical features, use of healthcare resources, and short-term outcomes were examined. Average annual percent changes (AAPCs) were derived.Results: C-ICU hospitalizations (n = 7,552) became (AAPC) increasingly younger (age ≥ 65 years: -1.0%/year). The Charslon comorbidity index rose 4.2%/year, while the mean number of organ failures (OFs) increased by 8.2%/year, with a fast rise in the rate of those developing ≥ 3 OFs (+15.5%/year). Between 2001 and 2010, there was no significant change in utilization of mechanical ventilation and new hemodialysis among C-ICU hospitalizations with reported respiratory and renal failures (68.9% vs. 73.3%, P = 0.3653 and 15.5% vs. 21.8%, P = 0.8589, respectively). Hospital length of stay or total hospital charges remained unchanged during study period. Hospital mortality decreased between 2001 and 2010 from 39.3% to 23.8% (-5.2%/year). The majority of hospital survivors (61.6%) were discharged to another facility, and increasingly to long-term acute care hospitals, with routine home discharge decreasing to 11% by 2010.Conclusions: C-ICU hospitalizations demonstrated increasing comorbidity burden and rising development of OF, and matching rise in use of selected life-support interventions, though with unchanged in-hospital fiscal impact. There has been marked decrease in hospital mortality, but survivors had substantial residual morbidity with the majority discharged increasingly to another post-acute care facility.J Clin Med Res. 2016;8(4):303-311doi: http://dx.doi.org/10.14740/jocmr2484w
机译：背景：关于重症监护病房（ICU）管理的念珠菌血症的纵向分布模式的研究结果参差不齐，缺乏有关患者临床特征和结局的相应演变模式的报道。没有关于ICU管理的念珠菌病成年患者的属性，护理和预后的时间趋势的人群水平数据。方法：德克萨斯州住院病人公共用途数据文件用于识别18岁或以上诊断为念珠菌病的住院患者。以及2001年至2010年的ICU入院（C-ICU住院）。研究了人口统计学，临床特征，医疗保健资源的使用和短期结果的时间趋势。结果：C-ICU住院治疗（n = 7552）变得更年轻（AAPC）（年龄≥65岁：-1.0％/年）。 Charslon合并症指数上升了4.2％/年，而平均器官衰竭（OFs）数量增加了8.2％/年，其中≥3个OFs的比率迅速上升（+ 15.5％/年）。在2001年至2010年之间，报告呼吸和肾功能衰竭的C-ICU住院患者在使用机械通气和进行新的血液透析方面无显着变化（68.9％比73.3％，P = 0.3653和15.5％vs. 21.8％，P =分别为0.8589）。在研究期间，住院时间或总住院费用保持不变。医院死亡率在2001年至2010年期间从39.3％降至23.8％（-5.2％/年）。大多数医院幸存者（61.6％）出院到另一家医院，并越来越多地送往长期急诊医院，到2010年常规家庭出院率下降到11％。尽管对医院的财政影响没有变化，但OF的使用以及与之相匹配的选择生命支持干预措施的使用有所增加。医院的死亡率已显着降低，但幸存者的病残率仍然很高，大多数病人越来越多地出院到另一家急症后护理机构。JClin Med Res。 2016; 8（4）：303-311doi：http://dx.doi.org/10.14740/jocmr2484w

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