医院前发作:基于医疗点检测的短期结果和风险分层
María I Donoso-Calero1, José L Martín Conty1, Raúl López-Izquierdo2,3
1Faculty of Health Sciences, Universidad de Castilla la Mancha, Talavera de la Reina, Spain.
European journal of clinical investigation
|June 16, 2023
概括
医院前的发作会影响患者的病情. 这项研究确定了预测临床损伤和死亡率的因素,表明改善医院前评估可以提高结果.
科学领域:
- 神经学 神经学
- 紧急医疗 紧急医疗
- 临床风险评估临床风险评估
背景情况:
- 关于医院前发作管理和紧急医疗服务 (EMS) 风险分层的数据有限.
- 这种差距阻碍了在医院抵达前有效的患者护理和评估.
研究的目的:
- 为了确定与临床损伤相关的因素,在患者与医院前发作.
- 确定2,7日和30日累积住院死亡率的风险因素.
主要方法:
- 跨西班牙EMS单位和急救部门的前性多中心研究.
- 涉及517名患有医院前发作的成年患者.
- 使用后勤回归分析人口统计,生命体征,实验室数据,以及中毒或创伤性脑损伤 (TBI) 的存在.
主要成果:
- 14.9%的患者经历了临床损伤;死亡率为3.4% (2天),4.6% (7天) 和7.7% (30天).
- 损伤的危险因素包括呼吸速率,二氧化碳水平,肌肉损伤,创伤或中风;更高的格拉斯哥昏迷量表 (GCS) 评分是保护性的.
- 死亡风险因素包括年龄,,葡萄糖,机械通风和中风;氧和,GCS和血红蛋白具有保护作用.
结论:
- 医院前变量有效预测患者的临床损伤和死亡率.
- 将这些变量纳入医院前决策可以改善患者的治疗结果.
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