在患有状细胞疾病的成年人中,急诊室的使用模式
Jean-Simon Rech1,2,3,4, Aline Santin2,3, François Lionnet2,3
1Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, Réseau Sentinelles, Paris, France.
British journal of haematology
|October 8, 2025
概括
患有状细胞疾病 (SCD) 的成年人经常使用急诊室 (ED). 这项研究确定了不同的ED使用模式,揭示了高使用率的患者在不同的爆发中体验访问,这表明了干预的潜在目标.
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) 通常导致成年人访问急诊室 (ED).
- 在SCD患者中,ED使用模式存在显著的变化.
研究的目的:
- 为了识别和描述ED在SCD成年人使用的典型模式.
- 分析与频繁的急救访问相关的时间变化和风险因素.
主要方法:
- 用一个生存模型来估计随时间推移累积的ED访问风险.
- 采用聚类方法来确定不同的ED使用模式.
- 分析了656名患有SCD的成年人和2013-2019年期间9080次ED访问的数据.
主要成果:
- 确定了两个不同的ED使用集群:一个低使用组 (81%的个人) 和一个高使用组 (19%).
- 高度使用的人经常在"爆发"中经历ED访问 (3个月内≥3次访问,基线率≥3倍).
- 一个月内两次ED访问显著增加了下一个月再次访问的风险 (aHR 3.51).
结论:
- 成年SCD患者表现出异质的ED利用率,其中一个子群体经历了高频率,类似爆发的访问.
- 了解这些爆发的触发因素对于开发有针对性的干预措施至关重要.
- 旨在管理急性事件和防止后续访问的干预措施可以减少ED的整体负担.
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