随着时间的推移改变严重呼吸衰竭的临床实践和预后:全国性住院患者数据库研究
Takuo Yoshida1, Sayuri Shimizu2, Kiyohide Fushimi3
1Department of Health Data Science, Graduate School of Data Science, Yokohama City University, 22-2, Seto, Kanazawa, Yokohama, 236-0027, Japan; Department of Emergency Medicine, The Jikei University School of Medicine, 3-19-18, Nishi-Shinbashi, Minato-ku, Tokyo 105-8471, Japan.
严重呼吸衰竭的临床实践在2016-2019年之间发展. 辅助疗法发生了变化,改善了基于证据的护理,并在机械通风患者的医院死亡率上略有降低.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 严重的呼吸衰竭需要复杂的干预措施.
- 呼吸衰竭的临床管理策略是动态的.
- 了解严重呼吸衰竭护理中的时间趋势至关重要.
研究的目的:
- 分析严重呼吸衰竭的临床实践和预后.
- 为了识别随着时间的推移严重呼吸衰竭管理的变化.
- 评估辅助疗法的趋势和结果.
主要方法:
- 全国范围的日本行政数据库 (2016-2019).
- 包括患有严重呼吸衰竭 (不包括慢性肺衰竭) 的非手术患者,需要机械通风>4天.
- 研究了患者特征,干预措施和预后的趋势.
主要成果:
- 分析了66905名患者;90%接受了抗生素,51%进入重症监护室.
- 医院死亡率为35%;中位数为10天的机械通风;23%的气管切除术.
- 观察到辅助疗法 (例如芬太尼,早期康复,ECMO) 的显著变化;医院死亡率略有下降 (36%至34%).
结论:
- 在2016-2019年期间,严重呼吸衰竭的辅助疗法发生了显著的变化.
- 趋势表明,基于证据的实践正在增加.
- 在研究期间,观察到医院死亡率的适度降低.
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