所有原因和恶化相关的转录在需要血分泌的血栓性微血管病症:一个基于人口的队列研究
Alexander R Thebert1, Toru Yoshino2, Sae X Morita3
1University of Kentucky College of Medicine, Department of Internal Medicine, Lexington, KY, United States
概括
需要等离子体修复的血栓性微血管病变 (TMA) 患者面临高再接收风险. 仅使用TMA的患者在30天内与恶化相关的再入院风险翻了一番.
科学领域:
- 血液学 血液学 血液学
- 内部医学 内部医学
- 关键护理医学 关键护理医学
背景情况:
- 血栓式微血管病变 (TMA) 是一种严重的疾病,复发率很高.
- 患有TMA的患者通常需要等离子体合成,这是一种与大量医疗利用相关的治疗方法.
- 了解再接收风险对于优化患者护理途径至关重要.
研究的目的:
- 调查住院TMA患者的所有原因和恶化相关的再接收风险.
- 为了确定与增加的再接收率相关的因素,后等离子体化.
主要方法:
- 2020年全国再接收数据库的二次分析.
- 在18岁以上的患者中,包括需要血合成的TMA非选择性入院.
- 利用多变量后勤回归和考克斯比例危险模型来评估再接收风险.
主要成果:
- 仅使用TMA的患者患30天恶化相关再入院的风险增加了2.1倍 (AHR:2.10,p=0.04).
- 与恶化相关的再入院在仅接受TMA的患者中较为频繁 (30天后为13.7%),而与患有先导性疾病的患者相比 (6.4%).
- 农村居住和患者直接出院成为重新入院的潜在风险因素.
结论:
- 出院后的护理和治疗策略需要加强,以减轻TMA再入院的风险.
- 需要有针对性的干预措施来减少与恶化相关的再入院,特别是在高风险的TMA人群中.
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