Mortality and Discharge to Home After Closed Brain Biopsy: Analysis of 3523 Cases from the State of California, 2003-2009
Mortality and Discharge to Home After Closed Brain Biopsy: Analysis of 3523 Cases from the State of California, 2003-2009
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DOI：
10.1016/j.wneu.2012.03.033
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发表时间：
2013-01-01
影响因子：
2
通讯作者：
Hammack, Julie E.
中科院分区：
文献类型：
--
作者：
Johnson, Derek R.;O'Neill, Brian P.;Hammack, Julie E.
目的：闭合（经皮）脑活检是一种重要的诊断程序。活检后患者结局的信息主要来自单机构系列或基于人群的样本，其中包括在可能不反映当前神经外科实践的时期内接受治疗的患者。我们试图确定在医院死亡率和出院回家后，封闭脑活检，这些结果的预测因素，通过使用一个大型的人口为基础的出院数据库与接近完整的情况acquisition.METHODS：2003年和2009年之间，在非联邦医院内的加州进行了封闭的脑活检出院数据库。分析了从家中入院的成人患者;回顾了患者水平和医院水平的因素，以预测院内死亡率和出院回家。Logistic回归用于确定显着的outcome.Results预测：在7年期间，3523住院，包括闭合脑活检，符合我们的纳入标准。总体住院死亡率为3.5%，67.2%的住院患者出院后直接回家。在多变量分析中，计划与非计划入院和患者种族是死亡率的预测因素。患者年龄，医院活检体积，计划与计划外入院，和病人的种族出院到home.CONCLUSIONS：封闭式脑活检是与一个更大的死亡率比一般公认的预测。大多数患者能够在活检后直接回家，但在手术量较低的医院，出院回家的比率较低。
OBJECTIVE: Closed (percutaneous) brain biopsy is an important diagnostic procedure. Information on patient outcomes after biopsy come largely from single-institution series or population-based samples that include patients treated during periods that may not reflect current neurosurgical practice. We sought to determine the rates of in-hospital mortality and discharge to home after closed brain biopsy, and predictors of these outcomes by using a large population-based hospital discharge database with near-complete case ascertainment.METHODS: All closed brain biopsies performed in nonfederal hospitals within the State of California between 2003 and 2009 were identified from a discharge database. Adult patients admitted from home were analyzed; patient-level and hospital-level factors were reviewed for predictors of in-hospital mortality and discharge to home. Logistic regression was used to determine significant predictors of outcome.RESULTS: During the 7-year period, 3523 hospitalizations, including closed brain biopsy, met our inclusion criteria. Overall in-hospital mortality rate was 3.5%, and 67.2% of hospitalizations were followed by discharge directly to home. Scheduled versus unscheduled admission and patient race were predictors of mortality in multivariate analysis. Patient age, hospital biopsy volume, scheduled versus unscheduled admission, and patient race were predictors of discharge to home.CONCLUSIONS: Closed brain biopsy is associated with a greater rate of mortality than is generally recognized. Most patients are able to return to home directly after biopsy, but the rate of discharge to home is lower at hospitals with lower procedure volumes.