对于患有急性中风的医疗保险受益人而言,输管的频率和与患者结果的关联
Laura G Burke1, Corey R Fehnel1, Ryan C Burke1
1From the Department of Emergency Medicine (L.G.B., R.C.B., J.E.); Department of Neurology (C.R.F., L.R.C., S.K.), Beth Israel Deaconess Medical Center and Harvard Medical School; Division of General Internal Medicine (E.J.O.), Brigham and Women's Hospital; and The Harvard T.H. Chan School of Public Health in Boston (L.G.B., J.E.), MA.
Neurology
|January 31, 2024
概括
急性中风的输管率有很大差异,医院的更高率与患者死亡率的增加有关. 这凸显了急性中风护理需要更清晰的指导方针的需要.
科学领域:
- 神经学 神经学
- 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:
- 在美国,急性中风的输管是常见的手术.
- 对于急性中风患者的输管治疗缺乏确定的指导方针.
- 了解输管实践的变化及其结果对于改善患者护理至关重要.
研究的目的:
- 调查急性中风患者的输管相关因素.
- 检查医院输管率与患者死亡率之间的关系.
- 在不同医院类型和患者人口统计学中识别输管实践的变化.
主要方法:
- 对65-100岁的医疗保险受益人 (2011-2018) 的回顾性观察研究.
- 分析患者人口统计,慢性疾病,医院特征,中风亚型和血栓切除术.
- 线性概率模型用于识别与输管和30天死亡率相关的因素,根据患者和医院的特征进行调整.
主要成果:
- 分析了超过80万例中风住院病例.
- 输管率差异很大,中位数为4.8%,基于中风亚型和血栓切除术的显著差异.
- 输管率较高的医院显示30天调整后死亡率增加,尽管未测量的患者严重程度可能起作用.
结论:
- 在急性中风护理中的输管率受到患者和医院因素的影响.
- 较高的医院输管率与患者死亡率的增加有关.
- 需要进一步的研究,以了解未测量患者严重程度对这些结果的影响.
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