血流感染患者30天再入院的预测因素:基于人口的队列研究
Kim Oren Gradel1, Pavithra Laxsen Anru2, Stig Lønberg Nielsen3
1Center for Clinical Epidemiology, and Research Unit of Clinical Epidemiology, Department of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense C, Denmark. kim.gradel@rsyd.dk.
概括
近三分之一的患有血流感染 (BSI) 的患者在30天内重新入院. 预测因素包括男性性别,年轻年龄,并发病,特定微生物和先前住院,突出显示潜在干预的领域.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 医疗保健管理的管理
背景情况:
- 血流感染 (BSI) 是致病率和死亡率的重要原因.
- 住院再接收对医疗保健系统和患者的治疗结果造成了巨大的负担.
- 确定再接收预测因素对于制定有针对性的干预措施至关重要.
研究的目的:
- 确定血流感染 (BSI) 后30天再入院的关键预测因素.
- 区分所有原因,感染相关和计划外再接收的预测因素.
主要方法:
- 一项以人口为基础的研究分析了30843名幸存于第一个BSI发作 (2007-2016) 的患者.
- 用多变量竞争性风险回归来估计回收预测因子的亚危险比率 (sHRs).
- 检查的预测因素包括人口统计,并发病,致病微生物,停留时间 (LOS) 和之前的住院病例.
主要成果:
- 31.3%的患者在30天内重新入院; 34.5%是感染相关的,80%是计划外的.
- 更高的再接收风险与男性性别,年轻年龄 (0-15岁),并发症 (恶性瘤,肝病),非大肠杆菌BSI和较长的LOS有关.
- 之前的住院病例显著增加了再入院风险 (sHR为1.70在1-30天前).
- 较短的LOS (第一个四分位数) 与感染相关的再入院 (sHR 1.67) 有关.
结论:
- 很大一部分患者在BSI后经历了30天的再入院.
- 一些因素,包括患者的特征和感染特征,预测再录取.
- 需要进一步的研究,以确定这些再接收的可避免性,并告知预防策略.
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