TY - T1的ALS患者的医院利用趋势和结果JF -神经学乔-神经病学SP - 777 LP - 780 - 10.1212/01. wnl.0000233849.47首页744.60六世- 67 - 5是AU -理查德Dubinsky盟-杰弗里·陈盟Sue-Min赖Y1 - 2006/09/12 UR - //www.ez-admanager.com/content/67/5/777.abstract N2 -目的:检查医院死亡率、利用率和趋势的ALS患者在一个大型美国队列。方法:作者进行了回顾性队列比较,对1988年至2002年美国全国住院病人样本使用。他们发现了招生、并发症和程序使用ICD-9代码。结果包括入院的原因,成本(调整到2002美元),住院时间、放电处理,利用临终关怀服务。Significance was set a priori at p < 0.001. Results: They identified 17,249 records. The significant findings were that common morbidities increased over time (pneumonia [38.1% to 47.3%], respiratory failure [26.9% to 35.5%], and nutritional deficiency [43.0% to 56.3%]); the median length of stay dropped from 6 to 4 days; mean hospital charges increased from $21,574 to $24,314; the proportion of hospital deaths decreased over time (17.6% to 14.6%), whereas the proportion discharged to home health/hospice care (14.0% to 18.2%) and to long-term care facilities (13.2% to 27.9%) increased. The odds ratio (OR) of death was 5.03 (95% CI: 4.57 to 5.54) for those admitted with respiratory failure, 1.36 (1.24 to 1.50) for those with pneumonia, and 0.84 (0.77 to 0.92) for those with nutritional deficiency. Conclusion: The high OR of death in patients admitted for pneumonia or respiratory failure is likely associated with more advanced disease, whereas the protective effect of admission for nutritional deficiency is consistent with the predominance of bulbar symptoms and admission earlier in the disease. The trends during the 15 years of this administrative data set were for increasing comorbidities and higher utilization of end-of-life care. ER -