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实验室数据缺失对败血症诊断及时性的影响
Jonathan Y Lam1,2, Aaron Boussina1,2, Supreeth P Shashikumar1
1Department of Biomedical Informatics, University of California San Diego, La Jolla, CA 92093, United States.
JAMIA open
|September 24, 2024
概括
缺失的实验室结果导致败血症患者延迟诊断和器官衰竭的识别. 更及时的实验室评估可以改善败血症的识别和治疗的开始.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 临床病理学 临床病理学
背景情况:
- 败血症诊断依赖于及时识别器官功能障碍.
- 实验室测量对于识别败血症中器官衰竭至关重要.
- 诊断延迟可能会对患者的治疗结果产生负面影响.
研究的目的:
- 调查缺乏实验室数据对败血症诊断延迟的影响.
- 为了确定缺少的实验室结果是否有助于延迟器官衰竭的评估.
- 探索实验室数据缺失和败血症诊断及时性之间的关系.
主要方法:
- 两家UCSD医院 (2021-2024) 发生败血症的成人患者的回顾性分析.
- 评估器官衰竭的时间 (T_OF) 与临床败血症怀疑时间 (T_suspicion) 相比.
- 在T_suspicion之前和之后的T_OF患者之间的实验室数据完整性的比较.
主要成果:
- 在临床怀疑后,大量的败血症患者经历了器官衰竭 (48.7%在ED,30.8%在病房,14.4%在ICU).
- 在T_怀疑后患有T_OF的患者,实验室检测结果缺失的比率明显更高.
- 在所有医院设置中,有延迟器官衰竭识别的患者中,平均缺失实验室的数量更高.
结论:
- 缺失的实验室数据在败血症患者中很普遍,并且与器官衰竭的延迟识别有关.
- 通过迅速评估来解决实验室数据缺失的问题,可能能够更早地识别败血症.
- 更及时的实验室测试可以促进早期诊断和治疗开始的败血症.
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