在炎症性肠道疾病的爆发中,经常使用紧急护理的风险因素
Benjamin G Hassid1, Julia Wei2, Dana Sax3
1Department of Gastroenterology, The Permanente Medical Group, Oakland Medical Center, Oakland, California, USA.
概括
患有炎症性肠病 (IBD) 的患者经常需要紧急护理. 这项研究确定了情绪障碍和阿片类药物使用等因素,这些因素增加了IBD爆发重复访问急诊室的风险.
科学领域:
- 胃肠病学 胃肠病学
- 医疗保健服务研究 医疗服务研究
- 流行病学 流行病学
背景情况:
- 炎症性肠病 (IBD) 患者经常需要紧急治疗疾病爆发.
- 预测哪些患者有高风险经常访问急诊室 (ED) 仍然是一个挑战.
研究的目的:
- 为了确定与重复ED访问相关的患者特征,在首次IBD相关ED访问的六个月内重复ED访问.
- 为高风险IBD患者提供有针对性的干预信息.
主要方法:
- 对北加利福尼亚州Kaiser Permanente成年成员 (2009-2018) 的回顾性队列研究.
- 分析了人口统计,临床和医疗保健利用数据.
- 使用多变量负二项式回归来评估六个月内复发ED访问的风险.
主要成果:
- 在211名IBD患者中,有19.3%的患者在六个月内再次访问ED.
- 与风险增加相关的因素包括情绪障碍,阿片类药物处方和皮质类固醇处方.
- 年龄较大,收入较高和饮酒障碍与风险降低有关.
结论:
- 几个患者因素预测IBD爆发的复发性ED利用率.
- 针对高风险个体 (例如,情绪或阿片类药物使用障碍的人) 的有针对性的干预措施可能会改善护理.
- 门诊随访时间在这个队列中没有显著减少重复的ED访问.
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