| Objective: The inpatient neurosurgical diseases database of Sichuan Provincial People′s Hospital in the past 10 years was used to analyze the constitutive characteristics,evolution and prognosis of different inpatient neurosurgical diseases to provide reference for further study.Methods: The medical records data of 23,563 inpatients in the department of neurosurgery in Sichuan Provincial People′s Hospital from Jan 1,2007 to Dec 31,2016 were analyzed retrospectively.The constitutive characteristics as population distribution(gender,age),and surgical complications(intracranial infection),concomitant diseases,mortality and hospital prognosis of various diseases and the changes of these characteristics with time were analyzed statistically.Results:(1)The constitutive ratio and evolution of disease.The traumatic brain injury,cerebrovascular disease and brain tumors were the most common diseases of neurosurgery,but the constituent ratio of the disease was changed.The constituent annual ratio of the disease situated the first to the third was TBI,cerebrovascular disease and brain tumors before 2014 and the total constitutive.But the constituent annual ratio of the disease location was changed since 2014.Cerebrovascular disease(27.47%)exceeded TBI(26.60%)in 2014,so cerebrovascular disease became the first of the three major diseases.Brain tumors(23.86%)exceeded TBI(23.72%)in 2015.From then on,brain tumors became the second of the three major diseases.(2)The in-hospital mortality.The total in-hospital mortality rate was 5.94%,and the mortality of different diseases declined year by year,especially in TBI and cerebrovascular diseases.The mortality of TBI was 11.93% in 2007 and dropped to 3.61% in 2016.The mortality of cerebrovascular disease was 15.87% in 2007 and fallen to 4.72% in 2016.(3)The gender composition.The inpatients number of male was higher than female(male: female is 1.43:1).TBI was more common in men(2.94:1).Intracraninal aneurysm was more common in women over the age of 40(0.55:1).The intracranial malignant tumors commonly occurred in male,such as GBM(1.51:1),brain metastasis(1.49:1).On the other hand,the benign tumor occurred more in women,such as meningioma(0.46:1),schwannomas(0.55:1),and pituitary adenoma(0.88:1).Trigeminal neuralgia(0.57:1)and facial spasm(0.53:1)usually occurred in women.(4)The age distribution.TBI mainly occurred in the young and elderly,and the highest population proportion was in the middle age(38.41%).Totally 74.24% of chronic subdural hematoma occurred in those over 60 years old.Cerebrovascular disease was mainly occurred in the elderly(83.47%).Brain tumors were commonly occurred in the age of 18~65(79.54%).And 79.38% of GBM occurred in people over the age of 40 years.Trigeminal neuralgia(97.18%)and facial spasm(86.53%)occurred in people over the age of 40 years.(5)The onset of diseases.Totally 88.04% of the spontaneous SAH caused by ruptured intracranial aneurysm.And 67.25% of intracranial aneurysm patients presented with bleeding and 4.29% with oculomotor nerve palsy.Yet 46.88% of the c AVM received treatment because of bleeding.(6)Neurological surgery and postoperative intracranial infection.Except the TBI,while the increase of the neurosurgical operations,the incidence of postoperative intracranial infection rose.(7)Complications and the factors influencing prognosis.Hypertension was the most common concomitant disease.Age rising(OR=0.86,95%CI: 0.84-0.91),with hypertension(OR=0.91,95%CI: 0.83-0.99)and pulmonary infection(OR=0.72,95%CI: 0.64-0.80),the number of complication(except hypertension and pulmonary infection)(OR=0.89,5%CI: 0.87-0.19)were the risk factors of the mortality and decreased cure rate.Conclusion: The results from clinical materials of inpatients in the department of neurosurgery,Sichuan Provincial People′s Hospital in recent ten years suggest the findings bellow.(1)The cerebrovascular diseases,brain tumors have overtaken TBI became the first and second top threat to people in neurosurgical disease,and TBI became the third top neurosurgical disease gradually.(2)Men were more than women in hospitalized patients,and the middle-age people had the highest percentage of patients.There are differences in different diseases on age and gender distribution.(3)All kinds of disease′s mortality declined year by year.The efficacy of variable diseases has promoted year by year.Whlie the cerebrovascular diseases are still the top lethality disease and the lowest cure rate in neurosurgery.The study of the cerebrovascular diseases should be strengthen.(4)The comprehensive prevention and control of postoperative intracranial infection should be strengthened further.And the regular methods should be used to control the invalidism rate.(5)Male,age raising,with hypertension and pulmonary infection,the number of other concomitant disease or complication(except hypertension and pulmonary infection)are the risk factors of the prognosis. |
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