缺血性脑卒中患者TOAST分型的费用分析  

Analysis on Hospitalization Expense of Patients with Different Ischemic Stroke Subtypes by TOAST Criteria

作　　者：陈丹霞[1] 林鑫江[1] 陈小华[1] 吴英姿[1] 王敏[1] 

机构地区：[1]广东省汕头市汕头大学医学院第一附属医院病案统计室,515041

出　　处：《中华全科医学》2009年第7期775-776,共2页Chinese Journal of General Practice

基　　金：广东省汕头市科技计划项目(汕府[2006]82号)

摘　　要：目的了解住院缺血性脑卒中患者TOAST分型的住院成本,分析不同亚型住院成本差别。方法采用前瞻性队列研究方法,按照1989年WHO的脑卒中诊断标准,连续性登记2007年9月-2008年3月间入院的缺血性脑卒中患者(共243例),按照TOAST标准进行病因分型,分析其构成比例,利用SPSS11.0统计软件分别统计其住院费用、住院天数、床位费用、药物治疗费用、影像学检查及实验室检查费用、功能康复锻炼费用的情况。结果共纳入缺血性脑卒中患者243例。TOAST各亚型构成比如下:①心源性栓塞型(10%);②大动脉粥样硬化型(39%);③小动脉闭塞型(38%);④其他明确病因型(4%);⑤不明原因型(9%),各型比例中心源性栓塞及大动脉粥样硬化型较小动脉闭塞型住院总费用高,表现在治疗费用及药费上,其住院天数也相对较长,不明原因型其影像检查费用较小动脉闭塞组高。结论TOAST分型作为一种缺血性脑卒中病因分型方法,可为缺血性脑卒中的住院成本估计提供参考依据,针对不同脑卒中亚型在诊治上有所侧重。Objective To analysis the difference of hospitalization expense of patients with different ischemic stroke subtypes by TOAST criteria. Methods The clinical data of 243 inpatients with ischemic stroke by WHO standard from Sep. 2007 to Mar. 2008 were collected prospectively. After completing medical records and auxiliary diagnostic studies, all included patients were classified into 5 major ischemic stroke subtypes based on TOAST criteria. The hospitalization expense, hospitalization days, accommodation cost, medicine and treatment cost, imaging and laboratory examination cost, function exercise and rehabilitation cost were analyzed statistically by SPSS software package. Results Among 243 cases, the proportion of ischemic stroke subtypes by TOAST criteria was as follows ： cardiogenic shock 10%, large-artery atherosclerosis 39%, small-vessel occlusion 38%, stroke of other de- termined etiology 4%, stroke of undetermined etiology 9%. The hospitalization expense of cardiogenic shock and large-artery atherosclerosis were larger than that of small-vessel occlusion. Conclusion TOAST criteria is useful to evaluate the hospitalization expense of patients with ischemic stroke of different TOAST subtypes.

关 键 词：脑梗塞 住院费用 TOAST分型法 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R197.322[医药卫生—临床医学]