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碎片化创伤护理,死亡率和重大并发症之间的关联:优化受伤者在初始住院后的护理
Benjamin K Wang1, Allen Green2, Cheryl K Zogg3
1From the Department of Surgery, Stanford University Medical Center, Stanford, CA.
概括
成年创伤患者的碎片化护理,定义为重新入院到非指数医院,是常见的,并且与死亡率增加和重大并发症有关. 需要制定战略,防止遣返人员及其不利后果.
科学领域:
- 创伤外科手术是什么
- 医疗服务研究 医疗服务研究
- 患者的治疗结果.
背景情况:
- 分散的护理,特别是重新入院到非指数医院,与各种医疗学科的不良结果有关.
- 创伤患者面临着由于伤害的新兴性质和普遍的社会脆弱因素而面临分散护理的高风险.
研究的目的:
- 确定成年创伤幸存者中分散护理的全国负担.
- 评估指数医院与非指数医院再入院之间的关系,以及死亡率和重大并发症等结果.
主要方法:
- 使用2019-2020年国家再接收数据库进行的回顾性观察队列研究.
- 分析包括经历90天再入院的成年创伤患者,通过多变量回归识别风险因素和结果关联.
主要成果:
- 超过11.9%的成年创伤患者 (108,246/906,531) 重新入院90天,其中28%的人重返非指数医院.
- 与指数医院再入院相比,重新入院非指数医院与调整后的死亡率增加11%,重大并发症的调整后的几率增加12%有关.
- 败血症是最常见的主要再入院诊断,尿路感染和肺炎是常见的同时发生的感染.
结论:
- 九十天的再入院和分散的护理是成人创伤患者的重要问题.
- 分碎的护理独立地与增加的死亡率和重大并发症有关.
- 确定可修改的再接收风险因素对于开发干预措施来缓解分散护理负面影响至关重要.
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