种族/种族,护理质量,以及缺血性中风的结果
Lee H Schwamm1, Mathew J Reeves, Wenqin Pan
1Massachusetts General Hospital, 55 Fruit St, Boston MA 02114, USA. lschwamm@partners.org
Circulation
|March 24, 2010
概括
黑人中风患者获得的基于证据的护理比白人或西班牙裔患者少,可能会增加复发性中风风险. 然而,在"了解指南"中,所有种族群体的中风护理质量都有所改善.
科学领域:
- 神经学 神经学
- 公共卫生 公共卫生
- 健康 公平 卫生 公平
背景情况:
- 以前的研究表明,在中风治疗中存在种族/种族差异.
- 这项研究调查了黑人,西班牙裔和白人患者在质量改进计划中的中风护理差异.
研究的目的:
- 为了确定种族/种族是否影响中风护理质量.
- 分析中风性能指标和住院死亡率的差异.
主要方法:
- 分析了397257例在1181家医院内因缺血性中风而入院的病例,这些病例是"适应指导方针-中风"计划 (2003-2008) 中的病例.
- 医院住院死亡率和七次中风绩效指标的比较,按种族/种族分层.
- 对患者和医院级变量进行统计调整.
主要成果:
- 与白人患者相比,黑人患者接受关键中风治疗 (例如,IV血栓溶解,DVT预防,戒烟) 和脂质治疗的几率较低.
- 与白人患者相比,黑人患者的住院死亡率也较低.
- 西班牙裔患者在所有措施中都得到了与白人患者相似的护理,死亡率相似.
- 黑人和西班牙裔患者的住院时间都比白人患者长.
- 在研究期间,所有种族/族群的护理质量都有所改善.
结论:
- 与西班牙裔和白人患者相比,黑人中风患者获得的基于证据的护理过程较少.
- 这些差异可能导致黑人患者中风复发的风险更高.
- 随着时间的推移,Get With The Guidelines-Stroke计划显示了所有种族/族群中风治疗质量的显著改善.
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