社会决定因素和与心脏骤停和死亡率相关的预先停顿护理模式
Meghan M Dillan1, Joseph Piktel1, Kristen K Curtis1
1Department of Emergency Medicine, MetroHealth Campus, Case Western Reserve University, Cleveland, OH, USA.
Resuscitation
|July 25, 2024
概括
健康的社会决定因素显著影响心脏骤停 (CA) 的风险和结果. 了解这些在逮捕前护理和逮捕后死亡率方面的差异对于开发有针对性的干预措施以改善患者存活率至关重要.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 健康差异 在健康上的差异
背景情况:
- 健康的社会决定因素 (SDOH) 显著影响心脏骤停 (CA) 的风险和结果.
- 获得CA前的护理是改善生存率的关键因素.
- 大型医疗保健数据库提供了对影响医疗保健差距的人口统计和SDOH趋势的见解.
研究的目的:
- 为了确定CA的发病率和随后的死亡率在不同的患者人口统计学和社会决定因素.
- 描述与SDOH相关的逮捕前护理模式.
- 为了确定CA风险和结果的差异.
主要方法:
- 这是一项回顾性队列研究,使用了Epic Cosmos电子健康数据库 (22.7亿患者).
- 收录标准:CA (ICD-10-CM:I46) 的紧急部门 (ED) 遭遇.
- 对患者人口统计,社会脆弱性指数 (SVI),逮捕前的护理模式和逮捕后的死亡率 (7,30,180天) 的分析.
主要成果:
- CA发生率为0.11% (201,846次ED访问). 男性,黑人,夏威夷原住民/太平洋岛民和美洲印第安人/阿拉斯加原住民群体的CA发病率较高.
- 在最高的SVI四分位数中观察到较高的CA发病率.
- 在人口统计和SVI群体中,在逮捕前的护理 (ED vs 办公室访问) 和逮捕后的死亡率中发现了显著的差异,女性,黑人患者的死亡率最高,SVI的死亡率最高.
结论:
- SDOH极大地影响了CA风险,逮捕前的护理和逮捕后的死亡率.
- 确定SDOH对CA护理连续性的影响,为预防和改善生存提供了可行的目标.
- 解决健康差异对于减轻CA负担至关重要.
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