非特异性诊断患者中生命体征严重偏差-基于登记册的历史队列研究
Mia Carøe Sørensen1, Morten Breinholt Søvsø1, Erika Frischknecht Christensen1,2
1Centre for Prehospital and Emergency Research, Aalborg University and Aalborg University Hospital, Aalborg, Denmark.
没有特定诊断的救护车患者通常具有正常的生命体征和低死亡率. 然而,关键生命体征表明高死亡率,无论年龄或并发症.
科学领域:
- 紧急医疗 紧急医疗
- 临床诊断 临床诊断 临床诊断
- 公共卫生 公共卫生
背景情况:
- 很大一部分救护车患者接受非特定的医院诊断.
- 这些非特异性诊断不成比例地导致30天死亡率.
- 首次与医生接触时的生命体征可以表明患者的严重程度.
研究的目的:
- 为了确定异常生命体征的患病率,使用修改的国家早期预警分数2 (NEWS2) 在救护车患者的非特异性诊断.
- 在这个患者群体中,研究生命体征,NEWS2评分,诊断类型和死亡率之间的关联.
主要方法:
- 一项基于登记的队列研究,对丹麦北部的41539名救护车患者 (年龄16岁以上) (2012-2016).
- 患者接受了非特定的诊断 (ICD-10第R或Z章).
- NEWS2评分评估生命体征正常性;使用卡普兰-梅尔和后勤回归分析死亡率.
主要成果:
- 62.8%的患者有生命体征的偏差,其中6.8%的生命体征至关重要.
- 与正常相比,观察到不完整或偏离生命体征的死亡率更高.
- 关键生命体征患者的48小时和30天死亡率最高 (13.4%),不受年龄,性别或并发症调整的影响.
- Z039 (对疑似疾病的观察,未指明) 是生命体征组中最常见的诊断.
结论:
- 大多数非特异性诊断的救护车患者的生命体征正常或非关键,死亡率低.
- 一个小的子集 (大约. 4%) 具有关键生命体征的人面临着显著更高的死亡率,独立于人口因素或并发症.
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