Se Won Lee, Bryan Werner, Hyeyoung Park, Justin DeAndrea, Napatkamon Ayutyanont, Henry York
{"title":"美国大型私立医疗系统中脊髓损伤伴有脊椎骨折患者的人口、临床特征和住院过程的流行病学研究。","authors":"Se Won Lee, Bryan Werner, Hyeyoung Park, Justin DeAndrea, Napatkamon Ayutyanont, Henry York","doi":"10.1080/10790268.2023.2228582","DOIUrl":null,"url":null,"abstract":"<p><p><b>Objectives:</b> To evaluate the demographics, clinical characteristics, hospital course, and factors associated with outcomes in patients with spinal cord injury associated with vertebral fracture (SCI-VF).<b>Design:</b> Retrospective analysis of data collected from electronic health record.<b>Setting:</b> A large for-profit United States health care system.<b>Participants:</b> 2219 inpatients with SCI-VF between 2014 and 2020 identified using International Classification of Disease codes.<b>Main Outcome Measure:</b> In-hospital mortality, and disposition (home vs. no-home discharge) after hospitalization.<b>Results:</b> The mean age of patients admitted with a diagnosis of SCI-VF was 54.80 ± 20.85 years with 68.27% identified as male. The cervical spine was the most prevalent site of fracture, displaced vertebral fracture was the most common radiographic diagnosis, and the majority of injuries were classified as incomplete. 836 (37.67% of all 2219) patients were discharged home and had a shorter length of stay (7.56 ± 13.58 days) when compared to the average of the total study population (11.56 ± 19.2 days). The most common hospital-acquired complication (HAC) was falls (n = 259, 11.67%). Characteristics associated with in-hospital mortality in the 96 patients (6.94% of 1,383 patients with no-home discharge) included initial respiratory failure, ICU stay, increased medical comorbidity index value, insulin use, and presence of cardiovascular, pulmonary, and gastrointestinal HACs.<b>Conclusions:</b> A large observational study of patients with SCI-VF can add to the knowledge of SCI characteristics in the U.S. population. Recognizing the common hospital-acquired conditions and clinical characteristics associated with increased in-hospital mortality can be helpful to improve the care of patients with SCI-VF.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"933-943"},"PeriodicalIF":1.8000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533260/pdf/","citationCount":"0","resultStr":"{\"title\":\"Epidemiology of demographic, clinical characteristics and hospital course of patients with spinal cord injury associated with vertebral fracture in a large private health care system in the United States.\",\"authors\":\"Se Won Lee, Bryan Werner, Hyeyoung Park, Justin DeAndrea, Napatkamon Ayutyanont, Henry York\",\"doi\":\"10.1080/10790268.2023.2228582\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Objectives:</b> To evaluate the demographics, clinical characteristics, hospital course, and factors associated with outcomes in patients with spinal cord injury associated with vertebral fracture (SCI-VF).<b>Design:</b> Retrospective analysis of data collected from electronic health record.<b>Setting:</b> A large for-profit United States health care system.<b>Participants:</b> 2219 inpatients with SCI-VF between 2014 and 2020 identified using International Classification of Disease codes.<b>Main Outcome Measure:</b> In-hospital mortality, and disposition (home vs. no-home discharge) after hospitalization.<b>Results:</b> The mean age of patients admitted with a diagnosis of SCI-VF was 54.80 ± 20.85 years with 68.27% identified as male. The cervical spine was the most prevalent site of fracture, displaced vertebral fracture was the most common radiographic diagnosis, and the majority of injuries were classified as incomplete. 836 (37.67% of all 2219) patients were discharged home and had a shorter length of stay (7.56 ± 13.58 days) when compared to the average of the total study population (11.56 ± 19.2 days). The most common hospital-acquired complication (HAC) was falls (n = 259, 11.67%). Characteristics associated with in-hospital mortality in the 96 patients (6.94% of 1,383 patients with no-home discharge) included initial respiratory failure, ICU stay, increased medical comorbidity index value, insulin use, and presence of cardiovascular, pulmonary, and gastrointestinal HACs.<b>Conclusions:</b> A large observational study of patients with SCI-VF can add to the knowledge of SCI characteristics in the U.S. population. Recognizing the common hospital-acquired conditions and clinical characteristics associated with increased in-hospital mortality can be helpful to improve the care of patients with SCI-VF.</p>\",\"PeriodicalId\":50044,\"journal\":{\"name\":\"Journal of Spinal Cord Medicine\",\"volume\":\" \",\"pages\":\"933-943\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533260/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Spinal Cord Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/10790268.2023.2228582\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/7/10 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Spinal Cord Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/10790268.2023.2228582","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/7/10 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Epidemiology of demographic, clinical characteristics and hospital course of patients with spinal cord injury associated with vertebral fracture in a large private health care system in the United States.
Objectives: To evaluate the demographics, clinical characteristics, hospital course, and factors associated with outcomes in patients with spinal cord injury associated with vertebral fracture (SCI-VF).Design: Retrospective analysis of data collected from electronic health record.Setting: A large for-profit United States health care system.Participants: 2219 inpatients with SCI-VF between 2014 and 2020 identified using International Classification of Disease codes.Main Outcome Measure: In-hospital mortality, and disposition (home vs. no-home discharge) after hospitalization.Results: The mean age of patients admitted with a diagnosis of SCI-VF was 54.80 ± 20.85 years with 68.27% identified as male. The cervical spine was the most prevalent site of fracture, displaced vertebral fracture was the most common radiographic diagnosis, and the majority of injuries were classified as incomplete. 836 (37.67% of all 2219) patients were discharged home and had a shorter length of stay (7.56 ± 13.58 days) when compared to the average of the total study population (11.56 ± 19.2 days). The most common hospital-acquired complication (HAC) was falls (n = 259, 11.67%). Characteristics associated with in-hospital mortality in the 96 patients (6.94% of 1,383 patients with no-home discharge) included initial respiratory failure, ICU stay, increased medical comorbidity index value, insulin use, and presence of cardiovascular, pulmonary, and gastrointestinal HACs.Conclusions: A large observational study of patients with SCI-VF can add to the knowledge of SCI characteristics in the U.S. population. Recognizing the common hospital-acquired conditions and clinical characteristics associated with increased in-hospital mortality can be helpful to improve the care of patients with SCI-VF.
期刊介绍:
For more than three decades, The Journal of Spinal Cord Medicine has reflected the evolution of the field of spinal cord medicine. From its inception as a newsletter for physicians striving to provide the best of care, JSCM has matured into an international journal that serves professionals from all disciplines—medicine, nursing, therapy, engineering, psychology and social work.