自闭症和癫痫患者的住院治疗结果--一项基于人群的研究

IF 2 4区 医学 Q3 CLINICAL NEUROLOGY
Varun R. Subramaniam , Jonathan Goldstein , Lan Mu , Churl-Su Kwon
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引用次数: 0

摘要

自闭症是癫痫患者常见的合并诊断。了解这种双重诊断患者的健康需求和治疗效果对于优化医疗效果非常重要。我们对同时患有自闭症和癫痫的患者与单纯患有癫痫的患者的医院层面变量进行了比较。在 2003-14 年全国住院病人抽样(NIS)中,我们使用之前验证过的 ICD-9-CM 病例定义确定了单纯癫痫患者和同时患有自闭症和癫痫的患者的非选择性入院情况。一名同时患有癫痫和自闭症的患者与三名癫痫患者进行了年龄和性别配对。对相关结果进行了多项式逻辑回归分析。与单纯癫痫患者(n = 27762)相比,自闭症合并癫痫患者(n = 9254)转院几率更高(OR = 1.09,p = 0.048)、院内死亡率(OR = 1.36,p = 0.011)、平均住院时间更长(5.63 天 vs. 5.12 天,p <0.0001)和败血症(4.21 % vs. 3.08 %,p <0.0001)。两组患者的人口统计学、保险类型、社会经济地位和合并症的分布存在显著差异。我们的研究结果表明,合并自闭症和癫痫的患者是一个独特的群体,其健康结果与单纯癫痫患者有很大不同。鉴于双重诊断对住院轨迹的影响,必须采取有针对性的治疗方案,以优化这些患者的护理和住院效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
In-hospital outcomes in people with autism and epilepsy – A population-based study

Autism is a common comorbid diagnosis in those with epilepsy. Understanding the health needs and outcomes in patients with this dual diagnosis is important for optimizing healthcare outcomes. We compared hospital-level variables amongst patients with co-occurring autism and epilepsy, to those with epilepsy alone. Non-elective hospital admissions amongst patients with epilepsy alone and co-occurring autism and epilepsy were identified in the 2003–14 National Inpatient Sample (NIS) using previously validated ICD-9-CM case definitions. One patient with co-occurring epilepsy and autism was matched to three epilepsy patients for age and sex. Multinomial logistic regressions were performed to examine outcomes of interest. Compared to those with epilepsy alone (n = 27,762), patients with autism and epilepsy (n = 9254) had a higher odds of transfer to another facility (OR = 1.09, p = 0.048), in-hospital mortality (OR = 1.36, p = 0.011), longer mean length of stay (5.63 days vs. 5.12 days, p < 0.0001), and septicemia (4.21 % vs. 3.08 %, p < 0.0001). Distributions of demographics, insurance type, socioeconomic status, and comorbidities significantly differed between both groups. Our findings demonstrate that patients with comorbid autism and epilepsy are a unique population with health outcomes significantly differing from those with epilepsy alone. Given the effect that dual diagnosis has on hospital trajectory, focused treatment plans must be adopted to optimize care and hospital outcomes in these patients.

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来源期刊
Epilepsy Research
Epilepsy Research 医学-临床神经学
CiteScore
0.10
自引率
4.50%
发文量
143
审稿时长
62 days
期刊介绍: Epilepsy Research provides for publication of high quality articles in both basic and clinical epilepsy research, with a special emphasis on translational research that ultimately relates to epilepsy as a human condition. The journal is intended to provide a forum for reporting the best and most rigorous epilepsy research from all disciplines ranging from biophysics and molecular biology to epidemiological and psychosocial research. As such the journal will publish original papers relevant to epilepsy from any scientific discipline and also studies of a multidisciplinary nature. Clinical and experimental research papers adopting fresh conceptual approaches to the study of epilepsy and its treatment are encouraged. The overriding criteria for publication are novelty, significant clinical or experimental relevance, and interest to a multidisciplinary audience in the broad arena of epilepsy. Review articles focused on any topic of epilepsy research will also be considered, but only if they present an exceptionally clear synthesis of current knowledge and future directions of a research area, based on a critical assessment of the available data or on hypotheses that are likely to stimulate more critical thinking and further advances in an area of epilepsy research.
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