虚弱性及其与类风湿性关节炎患者再入院的关联:国家再入院数据库研究
Muhammad Waqas Tahir1, Yenny Rosli2, Christopher Leung3
1Mayo Clinic, Jacksonville, FL, USA.
Clinical rheumatology
|October 19, 2024
概括
与非虚弱个体相比,患有类风湿性关节炎 (RA) 的虚弱患者的再入院率和不良结果明显更高. 虚弱状态是识别风险RA患者住院后的关键指标.
科学领域:
- 老年学是一门学科.
- 类风湿病学 类风湿病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 虚弱状态尚未被确立为类风湿性关节炎 (RA) 患者再入院的风险因素.
- 了解虚弱的影响对于改善RA管理结果至关重要.
研究的目的:
- 确定虚弱状态是否会增加被诊断患有类风湿性关节炎的患者再入院的风险.
- 调查脆弱性与其他不良结果 (如住院患者死亡率和长期停留时间) 之间的关联.
主要方法:
- 利用2018年全国再接收数据库 (NRD) 来识别成人RA患者.
- 计算了医院脆弱性得分,将患者分为脆弱 (得分≥5) 和非脆弱 (得分<5) 组.
- 进行多变量考克斯比例危险分析,以评估脆弱对再接收风险的独立影响,以混因素进行调整.
主要成果:
- 分析了133187名RA患者;48.1%被归类为脆弱.
- 脆弱的RA患者的180天再入院率显著提高 (56.60%对30.61%).
- 虚弱的患者也经历了更高的住院死亡率 (3.36%对比0.39%) 和更长的LOS (26.24%对比7.82%).
- 脆弱性独立地与重新入院风险增加9%有关 (aHR,1.09;95% CI,1.08-1.11).
结论:
- 虚弱状态是风湿性关节炎患者再入院风险增加的重要独立预测因素.
- 脆弱的RA患者面临更高的住院不良结果风险,包括死亡率和长期LOS.
- 脆弱性评估可以帮助识别高风险的RA患者,以进行有针对性的干预和改进出院计划.
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