Cost-effective outcome for treating poor-grade subarachnoid hemorrhage
Cost-effective outcome for treating poor-grade subarachnoid hemorrhage
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DOI：
10.1161/01.str.0000089922.94684.13
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发表时间：
2003-10-01
期刊：
影响因子：
8.3
通讯作者：
Kirkpatrick, PJ
中科院分区：
文献类型：
--
作者：
Wilby, MJ;Sharp, M;Kirkpatrick, PJ
背景和目的-本研究的目的是前瞻性评估 1994 年至 2001 年间就诊于区域神经外科中心（英国剑桥阿登布鲁克医院）的低级别蛛网膜下腔出血患者的预后和费用。结果指标为 6 个月时的临床结果、获得良好结果所需治疗的人数 (NNT) 以及费用分析。方法 - 低级别患者（世界神经外科医生联合会 4 级和 4 级） 5）经插管和通气后转入神经重症监护病房。复苏并引流脑室脑脊液24小时后，停止镇静，并对患者进行临床评估。格拉斯哥运动评分 (GMS) 大于或等于 4 的患者接受了血管造影和手术治疗罪魁祸首动脉瘤。随后 GMS 为 6 的患者不被视为等级较差，并从研究中剔除。结果 - 我们认为 166 名通气患者确实等级较差（平均年龄，53.4 岁；94 名女性 [56.6%]）。其中，88 名患者（4
Background and Purpose-The goal of this study was to prospectively assess outcome and cost for poor-grade subarachnoid hemorrhage patients presenting to a regional neurosurgical center (Addenbrooke's Hospital, Cambridge, UK) between 1994 and 2001. Outcome measures were clinical outcome at 6 months, number needed to treat (NNT) for favorable outcomes, and cost analysis.Methods-Poor-grade patients (World Federation of Neurological Surgeons grades 4 and 5) were transferred to the neurocritical care unit after intubation and ventilation. After resuscitation and drainage of ventricular cerebrospinal fluid for 24 hours, sedation was stopped, and patients were assessed clinically. Patients with a Glasgow Motor Score (GMS) greater than or equal to4 underwent angiography and surgical treatment of culprit aneurysms. Patients with a subsequent GMS of 6 were not deemed poor grade and were discounted from the study.Results-We deemed 166 ventilated patients genuinely poor grade (mean age, 53.4 years; 94 women [56.6%]). Of these, 88 patients (4