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週末対平日の入院,急性肺栓塞後の死亡率
Drahomir Aujesky1, David Jiménez, Maria K Mor
1Service de Médecine Interne, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland. drahomir.aujesky@chuv.ch
Circulation
|February 11, 2009
まとめ
肺栓塞 (PE) の週末入院は,より高い短期死亡率と関連しています. 一貫性のある高品質のケアを週7日確保することは,すべてのPE患者にとって非常に重要です.
科学分野:
- 心臓病学 心臓病学
- 肺内医学は肺内医学である.
- 医療サービス 研究 医療サービス
背景:
- 最適な急性肺栓塞 (PE) 管理には,専門的な専門知識とリソースが必要です.
- この研究では,週末と平日の間に入院したPE患者のケアとアウトカムにおける潜在的な格差を調査しました.
研究 の 目的:
- 急性肺栓塞 (PE) 患者の30日間の死亡率と入院期間と,入院日 (平日と週末) が関連しているかどうかを判断する.
主な方法:
- ペンシルベニア州の186の病院 (2000-2002年) から,PEの初診で退院した15531人の患者の遡及的分析.
- 患者と病院の要因を調整して,週末入院と30日間の死亡率と退院時間の関連性を評価するために,ロジスティックおよび生存モデルを使用しました.
主要な成果:
- 週末に入院した患者 (21.2%) は,平日の入院と比較して,調整されていない30日間の死亡率 (11.1%対8.8%) が高かった.
- 調整した分析により,週末の入院で30日間の死亡率が著しく高いことが明らかになった (OR 1.17).
- 週末入院による死亡率の増加は重症患者の間で最も顕著であり,入院期間には違いはなかった.
結論:
- 急性肺栓塞 (PE) の週末入院は,短期的な死亡率が著しく高いことと関連しています.
- PEの管理を標準化し,週を通して一貫したケア提供を確保するために,品質改善のイニシアティブが必要です.
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