非计划性再入院,社区社会经济因素,以及它们对复杂胸前大动脉手术后的长期生存的影响
Ourania Preventza1, Jaymie Henry2, Lubna Khan2
1Division of Cardiothoracic Surgery, University of Virginia Health, Charlottesville, Va; Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex; Department of Cardiovascular Surgery, The Texas Heart Institute, Houston, Tex.
The Journal of thoracic and cardiovascular surgery
|January 31, 2024
概括
黑人患者和那些接受紧急大动脉手术的人面临着社会经济劣势和较低的生存率. 有针对性的后续护理对于改善这些高风险群体的结果至关重要.
科学领域:
- 心血管外科心血管外科
- 医疗保健服务研究 医疗服务研究
- 健康的社会经济决定因素
背景情况:
- 靠近大动脉手术后的非计划性再接收是一个重大的临床挑战.
- 了解社会经济因素在再接收和长期结果中的作用对于公平的护理至关重要.
研究的目的:
- 为了评估社区社会经济因素在患者经历无计划的再入院后近道大动脉手术.
- 在接受大动脉手术的患者群体中发现社会经济地位的差异.
主要方法:
- 在20年内对2339名接受近道大动脉手术的患者进行了回顾性审查.
- 分析60天内未计划的再接收情况,检查种族,敏度,性别和社会经济因素 (贫困,收入,教育).
- 卡普兰-梅尔生存率分析,以比较患者组的长期生存率.
主要成果:
- 与白人患者相比,黑人患者居住在贫困程度较高,收入较低,教育程度较低的地区.
- 与选择性病例相比,接受紧急或紧急手术的患者的社区收入和教育水平较低.
- 与白人患者相比,黑人患者的4年和6年生存率明显较差 (63.1%和89.1%在4年).
结论:
- 黑人患者和接受紧急大动脉手术的患者面临社会经济劣势,长期生存率较低.
- 建议对这些脆弱患者群体进行更早,更频繁的随访护理.
- 开发有针对性的放出后干预措施和可访问的校外诊所对于解决发现的差异至关重要.
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