对于非创伤性腹痛,PoCUS-first与CT-only:一种倾向性得分加权的队列研究,研究ED资源利用率
Te-Fa Chiu1,2, Tse-Chyuan Wong1,2, Fen-Wei Huang1
1Department of Emergency Medicine, China Medical University Hospital, No. 2, Yude Rd, Taichung, 404, Taiwan.
Internal and emergency medicine
|October 27, 2025
概括
护理点超声波 (PoCUS) 显著减少了急诊室停留时间和非创伤性腹痛的成本. 这种PoCUS-first策略可以提高效率,而不会影响患者的安全.
科学领域:
- 紧急医疗 紧急医疗
- 放射学 放射学是一门学科.
- 护理中心超声波检查
背景情况:
- 在急诊室 (ED) 的未分化,非创伤性腹痛中,点照顾超声波 (PoCUS) 的作用尚不清楚.
- 以前的研究表明,PoCUS可能会减少特定腹部诊断的停留时间 (LOS).
研究的目的:
- 为了将PoCUS-first策略与CT-only策略进行比较,用于非创伤性腹痛的成年患者.
- 评估这些策略与ED中资源利用和临床结果的关联.
主要方法:
- 一项倾向分数加权的队列研究包括26,403名成年ED访问非创伤性腹痛.
- 遭遇被分类为PoCUS-first (包括PoCUS单独或其次是CT) 或CT-only.
- 多变量回归和治疗权重的逆概率 (IPTW) 用于调整.
主要成果:
- 与CT-only相比,PoCUS-first策略与ED LOS减少了47%,ED成本减少了48%.
- 对于出院的患者来说,PoCUS-first带来了39%更短的LOS和53%更低的成本,以及更少的非计划回访.
- 在PoCUS-first方法下,没有观察到不良结果或安全问题增加.
结论:
- 对于非创伤性腹痛的初始风险分层的PoCUS-first策略与提高ED效率和减少资源使用有关.
- 这种方法似乎是安全和有效的,尽管当地的工作流变化可能会影响结果.
- 建议进行进一步的前性多中心研究以确认.
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