及时注入白蛋白可能会改善肝硬化和自发细菌性腹膜炎患者的资源利用
W Ray Kim1, Karthik Raghunathan2, Greg S Martin3
1Division of Gastroenterology and Hepatology Stanford University, Stanford, CA, USA.
BioMed research international
|June 20, 2024
概括
在肝硬化患者的自发性细菌性腹膜炎中,及时使用专素可显著减少住院时间,降低成本. 这种方法优化了这些关键患者的资源利用率.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 传染性疾病 传染性疾病
- 医疗保健服务研究 医疗服务研究
背景情况:
- 自发性细菌性腹膜炎 (SBP) 是肝硬化的一种严重并发症,导致医疗保健的使用增加.
- 已知白蛋白对SBP的生存益处,但其对医院资源利用率和最佳时间的影响尚不清楚.
研究的目的:
- 评估白素施用时间对住院时间和SBP需要液体复苏的肝硬化患者的总成本的影响.
- 为了确定早期阿尔伯明的使用是否与医院资源利用率的减少有关.
主要方法:
- 使用非识别的Cerner健康事实®数据 (2009-2018) 的回顾性研究.
- 包括成年住院患者肝硬化和SBP接受抗生素和液体复苏.
- 将患者分层分为"及时蛋白" (≤24小时) 和"非及时蛋白" (>24小时或没有蛋白) 组.
- 使用卡普兰-梅尔曲线和通用线性模型来分析出院时间和医院费用.
主要成果:
- 与"不及时"组 (7.78天) 相比",及时的白蛋白"组的住院时间中位数较短 (6.95天) (p=0.02).
- 及时服用白蛋白与16%较低的总医院费用相关 (p=0.027).
- 分析了1308例住院病例,其中301例具有有效的成本数据.
结论:
- 早期与抗生素一起服用白蛋白可能会减少住院时间,并降低SBP肝硬化患者的医疗费用.
- 优化白蛋白定时可以改善医院在这个患者群体的资源利用率.
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