识别患有潜在可预防的急诊室访问高风险的瘤病患,使用新的定义
Lauren Fleshner1,2,3,4, Sonal Gandhi2,4,5, Andrew Lagree1,2,3,6
1Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
JCO clinical cancer informatics
|October 30, 2024
概括
癌症患者的潜在可预防的急诊室 (ED) 访问是常见的,特别是在系统治疗的早期乳腺癌患者中. 识别这些患者可以帮助减少不必要的ED使用和成本.
科学领域:
- 在瘤学瘤学.
- 医疗保健管理的管理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 癌症患者经常使用急诊室 (ED).
- 这些访问的子集可能是潜在的可预防的 (PPED),影响护理质量和成本.
- 在瘤学中缺乏PPED的明确定义和风险因素.
研究的目的:
- 定义和描述与瘤学相关的PPED.
- 确定患有PPEDs高风险的患者子组.
- 为减少可避免的ED访问提供信息的有针对性的干预措施.
主要方法:
- 瘤病患者ED访问的回顾性分析 (2019年4月至2021年4月).
- 定义PPED为立即出院或入院 <48小时的访问.
- 使用描述性统计,物流回归和机器学习 (ML) 来进行趋势和风险分析.
主要成果:
- 分析了6689名瘤患者的13000多次ED访问.
- 62.1%的访问被归类为PPED.
- 对PPEDs的高风险组包括早期 (I-III) 乳腺癌患者和接受全身治疗的患者. 第四期肠道/肺癌患者和接近ED的人与非PPED有关.
结论:
- 对PPEDs的新定义显示,对识别有风险的瘤患者有希望.
- 接受全身治疗的早期乳腺癌患者是预防ED访问的干预措施的首选候选人.
- 机器学习模型为强大的PPED预测提供了一个有希望的途径,尽管需要验证.
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