在非创伤患者中进行病理学测试,这些患者以复发性发作到急诊室
Michael Burgess1, Simon Savage2, Robert Mitchell3
1School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Emergency medicine Australasia : EMA
|June 1, 2023
概括
大多数患有复发性的急诊室 (ED) 患者接受病理学测试,通常结果异常. 然而,这些发现很少改变急性患者管理,这表明过度使用测试.
科学领域:
- 紧急医疗 紧急医疗
- 临床病理学 临床病理学
- 神经学 神经学
背景情况:
- 过度的病理检测导致急诊室 (ED) 拥堵,医疗保健成本增加和患者的不良结果.
- 在患有无创性复发性发作的患者提交ED时,例行病理学测试的实用性需要评估.
研究的目的:
- 为了确定病理学测试的频率,产量和影响,在患有非创伤性复发性发作的患者中进行ED.
- 评估异常病理学结果对患者管理和抗药物治疗的影响.
主要方法:
- 从2017年到2020年,在澳大利亚成年ED中进行了一项回顾性队列研究.
- 包括那些呈现无创性复发性发作的患者.
- 主要结局包括测试频率,异常结果的比例,以及与管理变化的关联.
主要成果:
- 在398个 (86.9%) 符合条件的表现中,有346个涉及至少一个病理学测试.
- 在所有病理学测试中,18.3%的结果异常.
- 异常结果导致12种表现中的15种管理变化,与抗药物管理的变化有显著的关联 (OR 2.08).
结论:
- 大多数非创伤性复发性的ED表现包括病理学测试.
- 虽然异常结果很常见,但它们很少导致患者管理的急性变化.
- 在这种患者群体中,病理学测试可能被过度利用,尽管它们与抗药物调整有关.
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