社会脆弱性与手术后并发症和心血管手术患者再入院之间的关联
Ria Tilve1, Guangjin Zhou1, Jean-Luc A Maigrot2
1Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Population health management
|March 10, 2026
概括
使用ICD-10 Z代码识别的社会脆弱性增加了接受心脏手术的患者出现并发症和再入院的风险. 这些非医疗因素显著影响患者的治疗结果,强调了需要更好的评估的必要性.
科学领域:
- 心血管外科心血管外科
- 医疗保健服务研究 医疗服务研究
- 健康的社会决定因素
背景情况:
- 与健康相关的社会需求显著影响患者的治疗结果.
- 有限的研究存在于心脏手术患者的个人层面的社会脆弱性.
- ICD-10 Z-代码为承认社会需求提供了一种临床方法.
研究的目的:
- 评估个人层面的社会脆弱性与心脏手术患者的术后并发症和再入院之间的关联.
- 检查ICD-10 Z-代码在识别影响该人群结果的非医学因素方面的实用性.
主要方法:
- 对2016-2018年全国再接收数据库的回顾性分析.
- 包括接受重大心脏手术 (CABG,大动脉,门或组合) 的患者.
- 在六个领域 (就业,家庭,住房,心理社会,社会经济,依赖) 使用ICD-10 Z-代码评估社会脆弱性.
- 按社会脆弱性地位分层和多变量后勤回归分析.
主要成果:
- 与依赖相关的需求是最经常记录的社会脆弱性.
- 具有社会脆弱性的患者经历了更长的住院时间,更高的并发症患病率,再入院和并发症.
- 社会脆弱性与并发症 (OR 1.12) 和90天再入院 (OR 1.15) 的几率增加有关.
结论:
- 临床上承认的社会脆弱性与心脏手术后并发症和再入院的可能性更高有关.
- ICD-10 Z-代码可以识别影响患者结果的非医学因素.
- 为了获得最佳的临床实用性,需要对Z码进行进一步的标准化和评估.
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