很少进行测试或治疗,但很普遍:在ED观察单位的胸痛患者中高胆固醇血症
Nicklaus P Ashburn1, Anna C Snavely2, Rishi Rikhi3
1Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA; Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
The American journal of emergency medicine
|June 17, 2023
概括
高胆固醇血 (HCL) 检测和治疗往往是急诊室观察单位 (EDOU) 对于胸痛患者的错过机会. 早期干预可以显著降低心血管疾病的风险.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 高胆固醇血症 (HCL) 在急诊室 (ED) 患有胸痛的患者中很普遍.
- 目前的ED/EDOU协议通常不涉及HCL测试或治疗.
- 这一差距代表了减少心血管风险的潜在错失机会.
研究的目的:
- 在EDOU环境中调查HCL测试和治疗错失机会的程度.
- 在EDOU中评估胸痛患者的HCL测试和治疗率.
- 根据种族和性别来识别HCL护理中的差异.
主要方法:
- 在EDOU (3/2019-2/2020) 中成年胸痛患者的回顾性观察队列研究.
- 用于评估HCL状态,测试 (脂质面板) 和治疗的电子健康记录.
- 一年后的随访数据分析了测试和治疗率.
- 多变量逻辑回归用于比较种族和性别的比率,调整共变量.
主要成果:
- 在649名EDOU胸痛患者中,55.8%的人知道HCL.
- 在索引访问期间,只有5.9%的人接受了HCL测试; 26.5%在一年内.
- 54.0%的HCL患者在1年内接受治疗.
- 在调整后,HCL测试和治疗率没有基于种族或性别的显著差异.
结论:
- 在患有HCL的EDOU胸痛患者中,很大一部分患者接受过不足的测试和治疗.
- 在EDOU访问后,HCL评估和治疗的低率表明错过了机会.
- 实施基于ED/EDOU的HCL管理可以减轻心血管疾病的风险.
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