诊断覆盖:物质使用障碍的延迟管理 脊髓损伤患者
Yasmin Arda1, Ikemsinachi C Nzenwa1, Vahe S Panossian1
1Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
The Journal of surgical research
|January 24, 2026
概括
在创伤患者中,有物质使用障碍 (SUD) 的诊断覆盖导致迟迟诊断和治疗形脏损伤. 这种偏见会对患者的护理产生负面影响,强调需要在创伤环境中进行进一步研究.
科学领域:
- 创伤外科 手术 创伤外科
- 认知偏差研究研究
- 公共卫生 公共卫生
背景情况:
- 诊断遮蔽是一种认知偏见,在这种情况下,先前存在的疾病会阻碍其他疾病的诊断.
- 药物和酒精使用障碍 (SUD) 可能会加剧创伤患者的诊断阴影.
- 这项研究调查了SUD对诊断形脏损伤的影响.
研究的目的:
- 为了探索在创伤患者的诊断覆盖与粗的脏损伤.
- 评估SUD对诊断和管理的及时性的影响.
- 量化SUD对患者结果的影响.
主要方法:
- 利用了2017-2020年美国外科医生学院创伤质量改进项目数据库.
- 鉴定了经过脊髓切除术的形脊髓损伤患者,按SUD状态分层.
- 采用多变量逻辑回归来分析SUD,延迟诊断/切除术和结果之间的关联.
主要成果:
- 与非SUD患者相比,SUD患者 (19%) 的脊髓切除术的中位时间明显更长.
- SUD与延迟诊断 (aOR=1.13) 和延迟脊髓切除术 (aOR=1.25) 的可能性增加有关.
- 在SUD患者中,复合并发症的发病率较高 (aOR=1.14) 和诊断/治疗延迟,即使不包括中毒患者.
结论:
- 诊断的掩盖,特别是在SUD的形脏损伤患者中,显然会对患者的护理产生负面影响.
- 这些发现强调了SUD对创伤诊断和管理及时性的可衡量的负面影响.
- 需要进一步的研究,以了解创伤护理中诊断覆盖的全部范围和影响.
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