周末与周日入院,以及急性肺栓塞后的死亡率
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
概括
肺栓塞 (PE) 的周末入院与更高的短期死亡率有关. 确保每周7天持续提供高质量的护理对于所有PE患者至关重要.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 最佳的急性肺栓塞 (PE) 管理需要专业的专业知识和资源,这些专业知识和资源可能根据每周的每一天而异.
- 这项研究调查了周末和周日入院的PE患者在护理和治疗结果中的潜在差异.
研究的目的:
- 确定入院日 (周日与周末) 是否与急性肺栓塞 (PE) 患者的30天死亡率和住院时间有关.
主要方法:
- 从186家宾夕法尼亚州医院 (2000-2002年) 追溯分析了15531名被诊断为PE的患者,这些患者初步诊断为PE.
- 使用后勤和生存模型来评估周末入院与30天死亡率和出院时间之间的关联,调整患者和医院因素.
主要成果:
- 与周末入院的患者 (21.2%) 相比,与周日入院的患者相比,未调整的30天死亡率 (11.1%与8.8%) 更高.
- 调整后的分析显示,周末入院患者30天死亡率的几率显著增加 (OR 1.17).
- 周末住院的死亡率增加在重病患者中最为明显;住院时间长度没有差异.
结论:
- 周末急性肺栓塞 (PE) 的入院与显著更高的短期死亡率有关.
- 需要采取质量改进举措,以标准化PE管理,并确保在整个星期内提供一致的护理.
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