在使用LACE指数的创伤患者中,再入院和死亡率
Joan H Brown1, Julie M Reichert1, Isabella L Filippone1
1Department of Surgery, Division of Trauma and Acute Care Surgery, Penn Medicine Lancaster General Health, Lancaster, PA, USA.
The American surgeon
|June 21, 2025
概括
创伤患者具有高LACE指数得分,参加后续预约的创伤患者的死亡率较低,但再入院率不低. 需要进一步的研究来优化LACE得分,以防止创伤再入院和死亡率.
科学领域:
- 创伤外科 手术 创伤外科
- 医疗保健管理的管理
- 患者的治疗结果.
背景情况:
- 创伤患者的再接收在出院后是一个重大挑战.
- 根据LACE指数 (住院时间,住院急性,并发症,急诊) 预测30天内死亡或重新入院.
- 高风险创伤患者的早期随访是缓解不良结果的策略.
研究的目的:
- 确定与创伤患者再入院和死亡率相关的因素.
- 评估LACE指数指导的随访预约对30天再接收和死亡率的影响.
- 测试LACE随访减少再入院和死亡率的假设.
主要方法:
- 在LACE后续实施之前和期间对创伤患者 (≥18岁) 的回顾性审查.
- 在两个时期内包括1788名患者:LACE (BL) 之前872名,LACE (DL) 期间914名.
- 单变量和多变量分析以评估再接收和死亡风险因素以及随访的影响.
主要成果:
- 在LACE期间 (DL) 的再录取率略高于之前 (BL).
- 与BL相比,DL期间的死亡率在DL期间较低.
- 多变量分析确定肝硬化是再接收的风险因素,商业保险是保护因素. 参与随访降低了死亡风险,但没有再接收风险.
结论:
- 在创伤患者中,参加LACE随访预约显著降低了30天的死亡率.
- 在这项研究中,LACE的随访并没有显著降低30天再入院率.
- 需要进一步的研究来完善LACE得分门,以防止创伤人群的再录取和死亡率.
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