实施一种正式的基于风险的方法来确定多学科CKD护理的候选人:描述性队列研究
Maoliosa Donald1, Robert G Weaver2, Michelle Smekal2
1Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, AB, Canada.
Canadian journal of kidney health and disease
|December 4, 2023
概括
使用衰竭风险方程 (KFRE) 的基于风险的方法可以安全地将慢性病 (CKD) 患者转移到不那么密集的护理,减少不良事件和资源使用.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 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:
- 功能衰竭风险方程 (KFRE) 是一个验证的工具,用于预测进展到末期病.
- 在科诊所实施一种正式的,基于风险的方法可以优化患者管理.
- 慢性病 (CKD) 的管理需要仔细考虑患者的风险和资源配置.
研究的目的:
- 评估基于风险的方法的实施,以确定多学科CKD护理的候选人.
- 评估CKD护理选择对临床结果的影响,包括功能衰竭和死亡率.
- 分析将患者转移到资源密集型护理途径的有效性.
主要方法:
- 一项以人口为基础的描述性队列研究在阿尔伯塔脏护理南方进行.
- 分析了在2017年至2019年期间参加或考虑参加多学科CKD诊所的患者.
- 包括CKD进展 (脏置换疗法),死亡,ED访问和住院等结果在不同的护理途径中进行了比较.
主要成果:
- 显著的大多数患者 (77%) 仍在或被录取到多学科的CKD诊所,中位数较高的2年功能衰竭风险 (34.7%).
- 仅由科医生 (18%) 或初级保健医生 (5%) 管理的患者的功能衰竭风险明显降低 (3.6%和0.8%).
- 没有由初级保健医生单独管理的患者开始置换疗法 (KRT),只有0.6%由科医生管理而没有多学科护理这样做. 在多学科诊所之外,不良事件的发生率较低.
结论:
- 一部分患有CKD的患者可以在不太资源密集的环境中安全管理,而不会增加不良事件的风险.
- 使用KFRE进行风险分层可以优化多学科CKD护理资源的分配.
- 这种方法支持高效的医疗保健服务,同时在CKD管理中保持患者安全.
相关概念视频
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