预测因恶性肠道阻塞而入院的患者再入院和死亡率的因素
Nova Xu1, Beatrice J Sun2, Tiffany M Yue1
1Stanford University School of Medicine, Stanford, CA, USA.
The American surgeon
|April 27, 2024
概括
恶性肠道阻塞 (MBO) 再录取受患者年龄和语言的影响. 早期息护理咨询对再入院和死亡率产生影响,强调需要进行多学科讨论以改善生活质量.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 恶性肠道阻塞 (MBO) 是晚期癌症患者的常见并发症,通常与预后不佳有关.
- 目前的管理指南和MBO的结果预测有限.
- 确定影响MBO患者结果的因素对于改善护理至关重要.
研究的目的:
- 为了确定与MBO后医院再入院相关的患者特异性因素.
- 确定与MBO入院后90天死亡率相关的患者特征.
- 探索息护理咨询对MBO结果的影响.
主要方法:
- 一个5年的回顾性审查 (2017-2022年) 患者的晚期胃肠道或妇科恶性瘤入院MBO.
- 数据收集包括人口统计,社会经济地位,瘤特征和住院患者的结果.
- 进行了多变量分析,以确定再接收和90天死亡率的预测因素.
主要成果:
- 不说英语的患者有明显更高的MBO再录取风险 (OR=2.82,P=.039).
- 年龄较大与MBO再入院风险降低有关 (OR=0.96,P=.007),而炎增加死亡风险 (OR=2.17,P=.043).
- 早期息护理 (PC) 咨询预测了较低的再入院率 (OR=0.24,P<.001),但更高的90天死亡率 (OR=3.20,P=.003).
结论:
- 患者的年龄,主要语言和息护理 (PC) 咨询是MBO再入院的重要预测因素,可能会影响90天死亡率.
- 鉴于MBO的缓解性质,优先考虑PC咨询和护理讨论的多学科目标至关重要.
- 这些干预措施可能会减少再入院并提高MBO患者的生活质量.
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