通过皮肤冠状动脉干预的种族和民族差异
Charleen Hsuan1, Michelle P Lin2, Alexis Zebrowski3,4,5
1Department of Health Policy and Administration, Pennsylvania State University, University Park.
JAMA network open
|September 18, 2025
概括
在ST段升高心肌梗塞 (STEMI) 的皮革冠状动脉干预 (PCI) 中的种族和种族差异在整个护理过程中持续存在. 在PCI接收的最大差异发生在转移的患者中,但最大的影响在初始的PCI-有能力的医院呈现中.
科学领域:
- 心血管医学 心血管医学
- 健康 公平 卫生 公平
- 医疗保健服务研究 医疗服务研究
背景情况:
- 来自少数种族和少数民族的ST段升高心肌梗塞 (STEMI) 患者不太可能接受指导方针推的皮肤冠状动脉干预 (PCI).
- 现有研究表明,在PCI接入方面,在STEMI治疗前和治疗期间都出现了差异.
- 在PCI接收中出现最显著差异的确切时间尚不清楚.
研究的目的:
- 为了确定在患者护理途径的哪一点,PCI接收的最实质性的差异发生在向急诊室呈现的STEMI患者中.
主要方法:
- 这项横截面研究分析了2011年至2021年期间在佛罗里达州医院接受治疗的成年STEMI患者的数据.
- 结果包括向具有PCI能力的医院呈现,PCI接收,转移状态和PCI接收转移后,与种族和民族群体进行比较.
- 对人口,临床和医院因素进行控制的物流回归模型,以评估PCI接收的差异.
主要成果:
- 与白人患者相比,西班牙裔和黑人患者在具有PCI能力的医院出现的可能性较小.
- 黑人患者在最初提交到具有PCI能力的医院时,PCI接收率较低.
- 黑人和西班牙裔患者的转移率和随后的PCI接收率也存在差异,这些患者提交给非PCI能力的医院.
结论:
- 对STEMI患者PCI接收的种族和种族差异在护理过程的多个阶段是明显的.
- 虽然在转移后的PCI接收中观察到最大的差异,但在患者护理方面,最具影响力的差异与PCI能力的设施的初始呈现有关.
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