"七月效应"对糖尿病酸性糖尿病患者的患者:一项全国性回顾性队列研究
Garry Francis-Morel1, Nehemias Guevara-Rodriguez2, Shellsea Portillo-Canales3
1Department of Medicine, Division of Internal Medicine, Saint Louis University Hospital, Saint Louis, Missouri, USA.
概括
新住院人员的培训从7月开始,但这项研究没有发现7月和8月期间入院的糖尿病酸症 (DKA) 患者的死亡率增加. 这表明,在这个过渡期内,患者的安全性得到了维护.
科学领域:
- 内部医学 内部医学
- 临界护理医学 临界护理医学
- 内分泌学 在内分泌学.
背景情况:
- 7月份每年涌入的新住院医生引发了人们对患者安全的担忧,特别是在重症患者中.
- 这种转变对糖尿病酸症 (DKA) 患者的死亡率的影响尚不清楚.
研究的目的:
- 调查7月和8月期间的住院,与新住院培训相吻合,是否会影响DKA患者的住院死亡率.
- 分析二次结果,包括住院时间,住院费用,以及机械通风,透析或血管压缩器的需要.
主要方法:
- 一项国家回顾性队列研究,利用国家住院患者样本数据库从2016年到2020年.
- 纳入标准侧重于18岁或以上的患有DKA的患者.
- 七月/八月入院患者与其他月份患者之间的结局比较,通过多变量逻辑回归计算调整的几率比率.
主要成果:
- 这项研究分析了250,990例因DKA而入院的病例.
- 7月和8月入院 (17%的病例) 与住院患者死亡率增加的几率无关 (调整后的几率比率为0.96,P=0.58).
- 没有观察到患者人口统计学,主要支付人,住院时间或住院期间总费用之间的显著差异.
结论:
- 7月和8月期间因糖尿病酸性糖尿病住院的患者并没有增加住院患者死亡的风险.
- 尽管新医疗住院人员的过渡,但患者护理和安全似乎仍在维持.
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