死亡率及其决定因素在急诊室的患者中
Mengistu Abebe Messelu1, Baye Tsegaye Amlak2, Gebrehiwot Berie Mekonnen3
1Department of Nursing, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia. abebemengistu7@gmail.com.
BMC emergency medicine
|July 18, 2024
概括
埃塞俄比亚的急救部门看到高死亡率,7.71%的患者死亡. 农村居住,失去意识,并发病和护理延迟显著增加死亡风险,需要紧急干预.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 紧急医疗 紧急医疗
背景情况:
- 传染性和非传染性疾病的高死亡率使得急诊室 (ED) 死亡率成为埃塞俄比亚的关键健康指标.
- 现有的研究显示出不一致性,缺乏关于ED死亡率的综合系统性审查或元分析.
- 这项研究解决了对埃塞俄比亚医院ED的聚合流行数据和决定性鉴定的需求.
研究的目的:
- 确定埃塞俄比亚医院急诊室死亡率的综合流行率.
- 确定与这些急诊室患者死亡率相关的关键决定因素.
主要方法:
- 一个系统的审查和元分析,遵循PRISMA指南.
- 在多个数据库中进行了搜索 (Medline/PubMed,谷歌学者等). 对于在2023年12月16日之前以英语出版的观察性研究.
- 利用乔安娜·布里格斯研究所的批判性评估工具和随机效应模型进行元分析,使用子组分析和元回归来探索异质性和出版偏见.
主要成果:
- 包括18项与21582名参与者的研究;汇总的ED死亡率为7.71% (95%CI:3.62,11.80).
- 观察到的地区差异:迪雷达瓦 (16.7%),阿姆哈拉 (12.89%),奥罗米亚 (10.28%),亚的斯亚贝巴 (4.35%).
- 关键的死亡率决定因素包括农村居住 (OR; 2.30),无意识 (OR; 3.86),并发病 (OR; 2.82),以及延迟获得医疗保健 (OR; 4.73).
结论:
- 埃塞俄比亚的ED死亡率高,强调迫切需要多方利益相关者合作,以改善患者的治疗结果.
- 诸如农村居住,无意识,并发症和延迟获得护理等因素是死亡率的重要预测因素.
- 建议包括加强医院前护理,提供者培训,及时转诊以及优化转诊医院的初始管理,以降低死亡率.
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