针对心脏骤停使用有针对性的温度管理的变化
Jonathan D Wolfe1, R J Waken1, Erika Fanous1
1Division of Cardiology, Department of Medicine.
The American journal of cardiology
|June 23, 2023
概括
针对性温度管理 (TTM) 在心脏骤停后很少使用,只有0.85%的患者接受它. 根据医院类型,地区和患者人口统计数据,获得TTM治疗是有限的,这表明在护理方面存在显著的差异.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 针对性温度管理 (TTM) 是心脏骤停后患者的关键干预措施.
- 目前缺乏关于心脏骤停后TTM可访问性和利用性的国家级数据.
- 了解影响TTM接收的因素对于改善患者的治疗结果至关重要.
研究的目的:
- 分析心脏骤停后使用TTM的国家趋势.
- 为了确定与TTM接收相关的患者和医院级因素.
- 评估TTM获取和交付方面的差异.
主要方法:
- 从2016-2019年对国家住院样本 (NIS) 数据库的回顾性分析.
- 使用ICD-10代码来识别心脏骤停和TTM接收的患者.
- 评估了患者人口统计,保险状况,医院特征和TTM管理之间的关联.
主要成果:
- 在478,419名心脏骤停患者中,只有0.85%接受了TTM.
- 使用TTM集中在城市的大型教学医院,区域差异很大.
- 年龄较大,女性性别,西班牙裔族裔和医疗保险和医疗补助保险与TTM可能性的降低有关,部分原因是医院接入不公平.
结论:
- 在全国范围内,TTM在心脏骤停后未得到充分利用.
- 基于医院类型,地理区域和患者社会经济因素,TTM获取存在显著差异.
- 需要采取干预措施来解决不平等问题,并改善所有适当的心脏骤停幸存者的TTM可访问性.
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