数字健康和住院息护理:一个队列对照研究
Baldev Malkit Singh1,2, Nisha Kumari-Dewat3, Adam Ryder4
1Institute of Digital Health, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK baldev.singh@nhs.net.
BMJ supportive & palliative care
|July 25, 2023
概括
生命末期患者主动基于风险和数据驱动的评估 (PRADA) 系统改善了生命末期护理. 在接近生命终点的患者中,PRADA减少了再入院和死亡.
科学领域:
- 抚慰性护理是一种缓解性护理.
- 医疗信息学 医疗信息学
- 老年医学 老年医学
背景情况:
- 在临终期的患者中观察到高的住院率和死亡率.
- 现有的护理模式往往无法充分解决这些患者的复杂需求.
- 需要创新的系统来改善终身护理结果.
研究的目的:
- 评估一种新型数字系统的有效性,即生命末期患者的主动基于风险和数据的评估 (PRADA).
- 确定PRADA是否可以减少临终期患者的住院和死亡.
- 评估PRADA对放免后结果的影响.
主要方法:
- 一项队列控制研究将使用PRADA (n=114) 的患者与接受标准护理 (n=3730) 的患者进行了比较.
- 该研究的重点是活着出院的患者在出院后90天内死亡.
- 使用1:1匹配来完善群体之间的比较.
主要成果:
- 普拉达组显示,在90天内死亡的可能性更高 (78.9%对46.2%),但死亡的时间更短 (58天对178天).
- 普拉达显著减少了住院复诊 (20.2%与37.9%) 和住院死亡 (4.4%与28.9%).
- 释放后非选择性入院或住院死亡的综合终点在PRADA组明显较低 (或0.45).
结论:
- 使用PRADA工具的专家息护理团队参与与更好的出院后结果有关.
- 普拉达显示出改善预后死亡的患者护理的潜力.
- 该系统促进了主动管理,并减少了终身护理中的不良事件.
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