在状细胞病患者中,医院再接收患者
Ruchika Goel1,2, Ping Yang1, Xianming Zhu1,3
1Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
JAMA network open
|June 17, 2025
概括
状细胞疾病 (SCD) 的医院再入院率仍然很高,约为34%,明显超过没有SCD的患者的比例. 有针对性的干预措施对于降低再接收风险和改善这种遗传性血液疾病患者的长期结果至关重要.
科学领域:
- 血液学 血液学 血液学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 状细胞疾病 (SCD) 是美国最常见的遗传性血液疾病.
- 尽管治疗方面取得了进展,但SCD患者的住院再诊仍然是一个重大问题.
- 关于SCD再接收的全国代表性数据有限.
研究的目的:
- 分析美国状细胞疾病 (SCD) 30天住院复诊的全国趋势.
- 确定与SCD成年患者再入院相关的因素.
主要方法:
- 从2016年到2021年使用全国再接收数据库 (NRD) 进行的队列研究.
- 包括成年患者 (18岁以上) 通过ICD-10-CM代码识别的SCD.
- 调查加权混合效应的Poisson回归分析了再接收风险和相关因素.
主要成果:
- 患有SCD的成年人有约34%的持续30天再入院风险,明显高于没有SCD的人的约12%.
- 年轻的患者 (18-29岁) 呈现出最高的再录取风险 (35.1%).
- 与更高的再接收相关的因素包括医疗保险/医疗补助保险和血管封闭性危机;更高的收入和红细胞输血与较低的风险有关.
结论:
- 与普通人群相比,患有SCD的患者面临30天再入院的风险要高得多.
- 需要预防性,疾病修饰性和治疗性干预措施来缓解再接收率.
- 改善SCD患者的治疗结果需要解决社会经济因素和优化治疗策略.
更多相关视频
05:23Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
19.7K
08:23Characterization of Sickling During Controlled Automated Deoxygenation with Oxygen Gradient Ektacytometry
Published on: November 5, 2019
10.0K
相关概念视频
01:16Kidney Transplant III: Nursing Management
88
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
88
01:20Rheumatic Heart Disease IV: Nursing Management
41
AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
41
01:24Hemodialysis II: Procedure and Complications
148
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
148
01:27Pulmonary Embolism III: Nursing Management
46
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
46
01:22Healthcare Associated Infections II: Preventive Measures
2.8K
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
2.8K
01:25Hemodialysis III: Nursing Management
215
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
215