在72小时禁食协议中添加β-基酸盐对住院时间的影响:质量改善报告
Michelle D Lundholm1, Dianna Jo Copley2, Vinni Makin1
1Department of Endocrinology, Diabetes and Metabolism, Cleveland Clinic, Cleveland, OH, USA.
概括
胰岛素瘤检测的72小时禁食时间可以使用β-基酸盐 (BHB) 水平缩短. 这样可以减少住院时间和费用,而不会错过任何胰岛素瘤病例.
科学领域:
- 内分泌学 在内分泌学.
- 代谢诊断 代谢诊断 代谢诊断
背景情况:
- 72小时的禁食是胰岛素瘤诊断的标准,但它是繁重和昂贵的.
- 平衡诊断准确性与患者舒适性和资源利用是个挑战.
研究的目的:
- 评估使用β-基酸盐 (BHB) 作为代谢指标来缩短住院患者的禁食时间,以检测胰岛素瘤.
- 评估是否结合BHB>2.7 mmol/L停止标准会影响胰岛素瘤的诊断准确性.
主要方法:
- 根据原始 (2018-2020) 和更新 (2020-2022) 协议进行72小时禁食的患者的回顾性审查.
- 更新的协议包括一个停止标准的β-基酸盐 (BHB) >2.7 mmol/L.
主要成果:
- 更新后的协议,包括BHB,将平均禁食时间从57.6小时减少到49.7小时 (P = .03).
- 这一变化导致累计住院患者禁食时间减少了376.5小时,医疗费用降低.
- 所有7例胰岛素瘤病例在43小时内被确定,BHB ≤1.2 mmol/L,表明没有错过诊断.
结论:
- 添加BHB>2.7 mmol/L的停止标准有效地减少了住院患者住院时间和成本.
- 这种以证据为基础的方法可以改善患者执法和医院资源管理,而不会影响胰岛素瘤检测.
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