在急诊室出院后的多病症和不良结果:基于人口的队列研究
Michael C Blayney1, Matthew J Reed2, John A Masterson1
1Department of Anaesthesia, Critical Care and Pain Medicine, Usher Institute, University of Edinburgh, Edinburgh, UK.
BMJ medicine
|August 26, 2024
概括
多种疾病,多种慢性疾病的存在,显著增加了急诊室患者的不良结果. 这些风险,包括较高的死亡率和住院率,在年轻人中显著增加.
科学领域:
- 公共卫生 公共卫生
- 老年学是一门学科.
- 紧急医疗 紧急医疗
背景情况:
- 多种疾病影响了急诊室的大量患者.
- 了解其对患者结果的影响对于医疗保健规划至关重要.
研究的目的:
- 研究急诊室 (ED) 参与者的多病症和以患者为中心的不良结果之间的关联.
- 将这些影响按年龄组分为层次.
主要方法:
- 一项基于人口的队列研究,利用ED,医院出院,癌症登记册和死亡率数据的链接数据.
- 综合发病率定义使用埃利克豪泽并发病率指数 (≥2种疾病).
- 多变量回归分析评估了与30天死亡率,住院,7天再入院和ED停留时间的关联,按年龄分层 (<65岁与≥65岁).
主要成果:
- 近10%的ED出诊涉及多病症患者.
- 多种疾病与显著更高的30天死亡率 (aOR1.81),住院 (aOR1.81),7天的ED重复治疗 (aOR1.41) 和更长的ED时间 (0.27小时) 相关.
- 年轻患者 (65岁以下) 的相关性更强,特别是30天死亡率 (老年患者的aOR为3.03对1.61).
结论:
- 多种疾病是急诊室环境中不良结果的重要预测因素.
- 多种疾病对不良结果的影响在年轻患者群体中不成比例地大.
- 随着多病症的增加,急救护理需要适应性策略,以应对日益增长的需求.
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