患者种族与急诊室身体限制使用在全州医院系统之间的关联
J David Gatz1, Benoit Stryckman1, Laurence S Magder2
1University of Maryland School of Medicine, Department of Emergency Medicine, USA.
The American journal of emergency medicine
|November 5, 2024
概括
与白人患者相比,黑人患者在急诊室 (ED) 身体克制的几率更高. 然而,这种关联比其他临床因素小,需要进一步调查潜在原因.
科学领域:
- 紧急医疗 紧急医疗
- 健康差距 研究 研究 研究 研究
- 患者安全 患者安全
背景情况:
- 在急诊室 (ED) 中使用身体束是一种关键的患者安全问题.
- 了解限制使用的种族差异对于公平的护理至关重要.
研究的目的:
- 量化患者种族与ED体力限制的使用之间的关联.
- 确定导致种族差异的因素限制应用.
主要方法:
- 在8个ED的896,527名成年患者遭遇的数据上进行了多变量逻辑回归分析.
- 该研究调整了许多共同变量,包括年龄,性别,敏度和到达方式.
- 排除标准包括已经被限制或来自拘留中心的患者.
主要成果:
- 与白人患者相比,黑人患者的身体克制率调整后增加了 (OR 1.26).
- 更高的克制率与严重的敏度 (ESI 1 vs 3+) 和执法或EMS到达有很强的关联.
- 对黑人患者来说,限制危险的差异在抵达后的第一个小时内仍然存在.
结论:
- 虽然黑人患者更容易受到约束,但相对于临床风险因素,效果大小相对适度.
- 需要进一步的研究来确定患者的特征或临床医生的偏见是否推动了这些差异.
- 告知有针对性的干预措施以减少ED限制使用的种族差异至关重要.
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