在从急诊室出院后重复临床检查
Zhenghong Liu1, Raziyeh Mohammadi2, Seyed Ehsan Saffari2
1Department of Emergency Medicine, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore. liuzhenghong@hotmail.com.
International journal of emergency medicine
|March 3, 2025
概括
在72小时内重复访问急诊室的情况很少见,但很严重. 识别急性脑血管疾病等危险因素可以帮助预防不良后果并改善患者的护理.
科学领域:
- 紧急医疗 紧急医疗
- 改善医疗保健质量 改善医疗保健质量
- 临床风险管理临床风险管理
背景情况:
- 紧急部门 (ED) 在72小时内重新访问是关键质量指标.
- 这些再访的子集是由于临床恶化而产生的,可能导致更高的敏度护理或死亡率.
- 识别关键重访及其风险因素对于制定有针对性的干预措施至关重要.
研究的目的:
- 在紧急部门出院后72小时内确定关键的再访.
- 确定与这些关键重访相关的风险因素.
- 为减少出院后临床恶化的策略提供信息.
主要方法:
- 在新加坡一家三级医院从2008年至2020年期间对ED出院的回顾性队列研究.
- 从电子健康记录 (EHR) 中提取的数据.
- 重症复诊定义为导致死亡或入院重症监护室/高度依赖的复诊;与非重症复诊相比.
主要成果:
- 在1,057,533次排放中,4.2%的人进行了72小时的再检查,其中0.12%被归类为危急.
- 较高的心率,平均动脉压和实验室异常与关键复诊有关.
- 重复临床检查的高概率与最初诊断的"急性脑血管疾病" (OR: 38.00),"其他胃肠道疾病" (OR: 3.10) 和"残留代码;未分类" (OR: 2.69) 有关.
结论:
- 退院后的重复临床检查很少发生,但不成比例地影响着伴随疾病的老年人.
- 专注于高风险诊断可以指导开发有效的患者随访策略.
- 需要进一步的研究来完善管理危险重复临床检查的患者的方法.
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