诊断的时间和长期结果对于出现呼吸困难的成年人
Urvee Karsanji1, Claire A Lawson2, Emily Petherick3
1Department of Respiratory Sciences, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.
Thorax
|November 24, 2025
概括
诊断慢性喘息的延迟与更糟糕的结果有关. 对于有解释性诊断的患者来说,早期诊断至关重要,因为等待超过六个月显著增加了死亡风险.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 临床流行病学临床流行病学
背景情况:
- 诊断延迟对慢性喘息结果的影响尚不清楚.
- 这项研究调查了慢性喘息诊断的时间及其与未来健康事件的关联.
研究的目的:
- 为了检查慢性喘息患者诊断所需的时间.
- 确定诊断延迟和随后的意外住院和死亡率之间的关联.
主要方法:
- 使用英国临床实践研究数据链接进行的回顾性队列研究.
- 涉及的成年人有呼吸困难的新代码,以前没有心肺呼吸系统疾病.
- 调整后的考克斯回归和里程碑分析被用于评估与住院和死亡率的关联.
主要成果:
- 66%的成年人在5年的中位数内接受了慢性喘息的解释性诊断.
- 2年内诊断与住院风险 (HR 1.25) 和死亡率 (HR 1.84) 的增加有关.
- 等待≥6个月的诊断显著增加了死亡风险 (6-24个月:HR 3.33;≥24个月:HR 13.30).
结论:
- 对于那些有喘息代码但没有随后的解释性诊断的人来说,结果似乎更好.
- 对于那些有解释性诊断的人来说,延迟诊断 (≥6个月) 与生存率降低有关.
- 诊断途径需要精细化,以区分患者群体,并加快诊断那些处于更高风险的人.
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