蛛网膜下腔出血后急性肺水肿：危险因素和合并症——来自美国全国数据库的分析

IF 3.8 2区医学 Q1 CRITICAL CARE MEDICINE

Journal of Intensive Care Pub Date : 2025-05-13 DOI:10.1186/s40560-025-00796-w

Alejandro Pando, Anil Kumar Tenneli, T Pradeep, Priyanka Augustine, Balamurali Krishna, Jeffrey Pradeep Raj

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引用次数: 0

摘要

背景：急性肺水肿（APE）是蛛网膜下腔出血（SAH）的一种罕见并发症，与发病率增加和临床预后差有关。关于该并发症的发生率和危险因素的文献有限，因此本研究需要进一步调查。方法：使用2016年至2021年全国住院患者样本（NIS）来识别初步诊断为非创伤性SAH的成年住院患者。单变量和多变量分析调整了患者人口统计学和合并症状态，用于表征与APE的统计关联。结果：2016年至2021年，共有42141例患者被确定为SAH。在这些患者中，960例（2.3%）发现有APE。APE与住院时间增加相关（20.0±18.9天vs. 11.6±14.3天），p结论：SAH后APE与复杂病程增加相关。神经外科医生和神经危重症医疗专业人员应该意识到与SAH后APE增加相关的合并症和因素，以改善患者的预后。

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Acute pulmonary edema after subarachnoid hemorrhage: risk factors and comorbidities-an analysis of a nationwide database from the United States.

Background: Acute pulmonary edema (APE) is a rare complication of subarachnoid hemorrhage (SAH) that is associated with increased morbidity and poor clinical outcomes. There is limited literature addressing the incidence and risk factors of this complication, highlighting the need for further investigation as undertaken in the present study.

Methods: The 2016 to 2021 National Inpatient Sample (NIS) was used to identify adult inpatients with a primary diagnosis of non-traumatic SAH. Univariate and multivariable analyses adjusting for patient demographics, and comorbidity status, were used to characterize statistical associations with APE.

Results: A total of 42,141 patients were identified as having SAH from 2016 to 2021. Of these patients, 960 patients (2.3%) were found to have APE. APE was associated with increased length of stay (20.0 ± 18.9 days vs. 11.6 ± 14.3, p < 0.001), increased total costs ($503,671.3 ± 647,729.9 vs. $238,724.6 ± 328,062.1, p < 0.001), increased number of days from admission to first procedure (3.5 ± 7.3 vs. 1.9 ± 4.9, p < 0.001), increased Elixhauser comorbidity index ≥ 3 (77.5% vs. 66.0%, p < 0.001), and increased mortality (40.2% vs. 22.5%, p < 0.001). After controlling for confounding factors, independent risk factors for APE in patients with non-traumatic SAH included: Coagulopathies (adjusted Odds Ratio [aOR]: 1.57, 95% confidence interval [CI] 1.31-1.89, p < 0.001), Fluid and Electrolyte Disorders (aOR: 2.54, CI 2.13-3.03, p < 0.001), Liver Disease (aOR: 1.37, CI 1.07-1.76, p = 0.013), Obesity (aOR: 1.47, CI 1.19-1.81, p = 0.003), Pulmonary Circulatory Disorder (aOR: 1.72, CI 1.31-2.26, p = 0.001), and Weight Loss (aOR: 1.67, CI 1.36-2.04, p < 0.001).

Conclusion: APE after SAH is associated with increased complicated hospital course. Neurosurgeons and Neurocritical care medical professionals should be aware of the comorbidities and factors associated with increased APE after SAH to improve patient outcomes.

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来源期刊

Journal of Intensive Care Medicine-Critical Care and Intensive Care Medicine

CiteScore

11.90

自引率

1.40%

发文量

审稿时长

15 weeks

期刊介绍： "Journal of Intensive Care" is an open access journal dedicated to the comprehensive coverage of intensive care medicine, providing a platform for the latest research and clinical insights in this critical field. The journal covers a wide range of topics, including intensive and critical care, trauma and surgical intensive care, pediatric intensive care, acute and emergency medicine, perioperative medicine, resuscitation, infection control, and organ dysfunction. Recognizing the importance of cultural diversity in healthcare practices, "Journal of Intensive Care" also encourages submissions that explore and discuss the cultural aspects of intensive care, aiming to promote a more inclusive and culturally sensitive approach to patient care. By fostering a global exchange of knowledge and expertise, the journal contributes to the continuous improvement of intensive care practices worldwide.