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在急诊室诊断的特征性急性肺栓塞病例,使用全州临床注册表重新访问
Alexander T Janke1, Adrian D Haimovich2, Courtney W Mangus3
1VA Center for Cliniical Management Research, Clinician Scholars Program, VA Ann Arbor Healthcare System, Ann Arbor, MI; Department of Emergency Medicine, University of Michigan, Ann Arbor, MI.
大约4.9%的急性肺栓塞 (PE) 病例涉及先前在10天内访问急诊室 (ED). 这突显了ED出院的患者潜在的诊断缺口和疾病进展.
科学领域:
- 紧急医疗 紧急医疗
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
背景情况:
- 急性肺栓塞 (PE) 是一个关键的诊断,通常在急诊室 (ED) 进行管理.
- 了解ED出院后的复诊率对于改善患者护理和诊断准确度至关重要.
研究的目的:
- 为了确定急性PE的发病率和特征,在ED诊断的急性PE在之前的ED访问后不久被释放.
- 为了确定患有PE更高复诊率的患者子组.
主要方法:
- 在2017年至2022年期间,使用全州临床注册表对40名ED患者进行了回顾性分析.
- 识别了急性PE的成年患者,并且在10天内先前访问ED,没有住院治疗.
- 根据先前的诊断 (COVID-19,心肺疾病,症状) 进行了再访率和分析子组的特征.
主要成果:
- 在24,525例急性勃起发作病例中,1202例 (4.9%) 在10天内获得了先前的ED排放 (每10,000例ED排放中有2.0例).
- 在之前的访问中,发现了COVID-19诊断 (19.4%),其他心肺疾病 (8.9%) 和非特异性心肺症状 (16.7%).
- 由于COVID-19,肺炎和多叶膜溢出而出院后,观察到更高的PE复诊率.
结论:
- 在20例急性勃起前列腺发作病例中,近1例与10天内再次接受ED检查有关.
- 这些再访可能表明错过了诊断机会,疾病进展或未解决的风险因素.
- 需要进一步研究先前 ED 访问的患者的诊断策略.
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