• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The spine journal: official journal of the North American Spine Society >Early intervention in cauda equina syndrome associated with better outcomes: a myth or reality? Insights from the Nationwide Inpatient Sample database (2005–2011)
【24h】

Early intervention in cauda equina syndrome associated with better outcomes: a myth or reality? Insights from the Nationwide Inpatient Sample database (2005–2011)

机译：早期干预患者与更好的结果相关的患者：神话或现实？ 来自全国住院性样本数据库的见解（2005-2011）

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Abstract Background Context Evidence-based consensus on timing to surgical decompression following symptom onset in patients with cauda equina syndrome (CES) is limited or widely debated. Purpose This study aimed to investigate whether timing to intervention in the management of patients with CES has an impact on outcomes. Study Design/Setting This is a retrospective cohort study. Patient Sample The patient sample included 4,066 adult patients with CES registered in the Nationwide Inpatient Sample database (2005–2011) and undergoing elective decompression surgery. Outcome Measures The outcome measures are inpatient mortality, unfavorable discharge (discharge to rehabilitation), prolonged length of stay (LOS>75th percentile), and high hospital charges in patients undergoing decompression for CES. Methods The patients were stratified into three categories based on timing to surgical intervention: (1) within 24 hours (n=1,846, 45.6%); (2) between 24 and 48 hours (n=1,080, 26.6%), and (3) beyond 48 hours (n=1,130, 27.8%). Multivariable logistic regression fitted with generalized estimating equations using the sandwich variance-covariance matrix estimator to account for the clustering of similar outcomes within hospitals was used to examine the association of timing to surgical intervention categories with binary primary end points. For metric end points (charges), we used the ordinary least squares model to test the effect of timing to intervention. Results The mean age of the cohort was 50.19±17.55 years and 41% were female. In comparison to patients operated within 24 hours, increased likelihood of inpatient mortality (odds ratio [OR]: 3.61, 95% confidence interval [CI]: 1.32–9.85, p=.012), unfavorable discharge (OR: 2.23, 95% CI: 1.87–2.66, p Conclusions Early intervention in CES, regardless of the subtype (complete or incomplete), has higher likelihood of improved inpatient outcomes. The odds of getting better were higher, however, with incomplete CES. The timing of intervention did not seem to matter in traumatic CES as compared with degenerative etiology. Prospective randomized controlled trials may further help elucidate the impact of early intervention on outcomes in patients with CES.
机译：摘要背景上下文基于循证循证对症状症状症状（CES）患者（CES）症状后的外科减压的共识是有限的或广泛的辩论。目的本研究旨在调查干预患者患者的疗效是否对结果产生影响。研究设计/设置这是一个回顾性的队列研究。患者样本患者样品包括4,066名成年患者在全国内注册的CES在全国住院性样本数据库（2005-2011）和接受选修减压手术。结果措施的结果措施是住院性的死亡率，不利的出院（恢复康复），延长逗留时间（LOS> 75百分位数），以及接受CES减压的患者的高医院费用。方法将患者分解为三类基于手术干预的时间：（1）在24小时内（n = 1,846,45.6％）; （2）24至48小时（n = 1,080,26.6％），（3）超过48小时（n = 1,130,27.8％）。使用夹层差异 - 协方差矩阵估计器的广义估计方程的多变量逻辑回归用于考虑医院内的类似结果的聚类，用于检查与二元初级终点的外科干预类别的时序协会。对于公制终点（收费），我们使用了普通的最小二乘模型来测试时间介入的效果。结果队列的平均年龄为50.19±17.55岁，41％是女性。与24小时内运行的患者相比，住院性死亡率的可能性增加（差距[或]：3.61,95％置信区间[CI]：1.32-9.85，P = .012），不利的出院（或：2.23,95％ CI：1.87-2.66，P结论CES的早期干预，无论亚型（完全或不完整），改善住院后结果的可能性更高。然而，随着CE不完整的情况下，变得更好的可能性更高。干预的时间与退行性病因相比，创伤性CES似乎并不重要。前瞻性随机对照试验可能进一步帮助阐明早期干预CES患者的结果的影响。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号