Characteristics of Patients Hospitalized to Community Hospitals With Malignant Brain Tumors and Factors Associated With Discharge Destination.

HCA healthcare journal of medicine Pub Date : 2024-08-01 eCollection Date: 2024-01-01 DOI:10.36518/2689-0216.1698
Se Won Lee, Thanapath D Thantacheva, Denny Mack
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Abstract

Background: Our main objective was to compare the characteristics and hospital outcomes of patients with primary and metastatic brain malignancies and to investigate the associated factors related to hospital outcomes.

Methods: We conducted a retrospective, cross-sectional study of 1628 patients with brain malignancies from 8 community hospitals between 2017 and 2022 who were identified using International Classification of Disease codes. A stepwise logistic regression was used to identify demographics and clinical characteristics associated with in-hospital mortality and home discharge.

Results: The median age was 65 years old, with 72.5% of patients having metastatic brain malignancies. After 7.2 days of hospital stay, 49.2% were discharged home, and 102 patients expired during hospitalization. Increased age, medical coverage by Medicare, hemiplegia or paraplegia, lower initial hemoglobin level, increased length of stay, and the use of electrolyte replacement, antibiotics, laxatives, heparin, and anticonvulsants were associated with a decreased likelihood of discharge to home. No medical insurance, Medicaid insurance coverage, comorbidities of cerebrovascular disorder, the need to stay in the intensive care unit, patient safety indicator events, and the use of antibiotics, oral analgesics, and ipratropium-albuterol were associated with increased odds of in-hospital mortality.

Conclusion: We identified several predictor variables that delineate differences between both mortality risk and home discharge in patients with primary and metastatic brain tumors. Understanding these predictor variables can be helpful in improving the acute and post-acute care of this population.

社区医院恶性脑肿瘤住院患者的特征及出院去向相关因素。
背景我们的主要目的是比较原发性和转移性脑恶性肿瘤患者的特征和住院治疗结果,并研究与住院治疗结果相关的因素:我们对2017年至2022年期间8家社区医院的1628名脑恶性肿瘤患者进行了回顾性横断面研究,这些患者是通过国际疾病分类代码确定的。研究采用逐步逻辑回归法来确定与院内死亡率和出院回家相关的人口统计学和临床特征:中位年龄为65岁,72.5%的患者患有转移性脑恶性肿瘤。住院7.2天后,49.2%的患者出院回家,102名患者在住院期间死亡。年龄增加、医疗保险覆盖范围扩大、偏瘫或截瘫、初始血红蛋白水平降低、住院时间延长以及使用电解质替代品、抗生素、泻药、肝素和抗惊厥药与出院回家的可能性降低有关。无医疗保险、医疗补助保险、合并脑血管疾病、需要入住重症监护室、患者安全指标事件以及使用抗生素、口服镇痛药和异丙托溴铵-盐酸克仑特罗与院内死亡几率增加有关:结论:我们发现了几个预测变量,这些变量可划分出原发性和转移性脑肿瘤患者的死亡风险和出院回家之间的差异。了解这些预测变量有助于改善该人群的急性期和急性期后护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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