Healthcare utilization and outcomes of spinal cord injured veterans with stage 3-4 pressure injuries.

IF 3.3 3区物理与天体物理 Q2 OPTICS

Journal of Luminescence Pub Date : 2024-05-01 Epub Date: 2022-04-04 DOI:10.1080/10790268.2022.2052500

Dominique Van Beest, Shannon J Koh, Yi-Ting Tzen, Jijia Wang, Dindi Moore-Matthews, Jennifer S Kargel, James B Cutrell, Roger J Bedimo, Bridget R Bennett, Wei-Han Tan

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引用次数: 0

Abstract

Background: Pressure injuries (PI) are a significant source of morbidity for individuals with spinal cord injury/disease (SCI/D). They are also associated with significant healthcare resource utilization including prolonged hospitalizations. However, the long-term outcomes in terms of wound recurrence-free survival, hospital readmission rates, and all-cause mortality in this population remain largely unknown.

Objective: To examine the clinical characteristics, healthcare utilization and outcomes of SCI Veterans hospitalized at the VA North Texas Health Care System (VANTHCS) SCI inpatient unit with stage 3 and 4 PI, and compare these between those who received a myocutaneous flap surgery (flap patients (FP)) and those treated medically (non-flap patients (NFP)).

Methods: A retrospective chart review was conducted of all adult patients admitted to the VANTHCS SCI/D unit with stage 3 or 4 pelvic PI between 1/1/2013 and 12/31/2018. Healthcare utilization and outcome information was extracted for pre-specified time points.

Results: 78 patients met criteria (113 hospitalizations; 27 FP; 51 NFP). Average length of stay (LOS) was 122 days; FP had a significantly higher LOS than NFP (P = 0.01). Average number of consults was 24. Estimated cost per hospitalization was $175,198. Readmission rate within 30 days was 12.39%. The mortality rate within 1 year of discharge was 21.57% for NFP, as opposed to 3.70% in the FP group. Only 5.00% of NFP wounds were healed at discharged with sustained healing at 1 year, significantly less than FP wounds (55.26%, P < 0.01).

Conclusions: Despite the high investment in terms of healthcare utilization, outcomes in terms of wound healing are poor. Additionally, nearly 22% of NFP died within one year of discharge. This calls into question the utility of prolonged hospitalizations for PI in the SCI/D population in terms of wound treatment efficacy, healthcare costs, and patient morbidity/mortality.

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患有第 3-4 期压伤的脊髓损伤退伍军人的医疗保健使用情况和结果。

背景：压伤（PI）是脊髓损伤/疾病（SCI/D）患者发病的一个重要原因。它们还与大量医疗资源的使用有关，包括长期住院。然而，这一人群在伤口无复发存活率、再入院率和全因死亡率方面的长期结果仍是未知数：研究在退伍军人事务部北德克萨斯医疗保健系统（VANTHCS）SCI 住院病房住院的第 3 期和第 4 期 PI 退伍军人的临床特征、医疗保健利用率和结果，并比较接受肌皮瓣手术的患者（皮瓣患者（FP））和接受药物治疗的患者（非皮瓣患者（NFP））的临床特征、医疗保健利用率和结果：对2013年1月1日至2018年12月31日期间入住VANTHCS SCI/D病房的所有骨盆PI 3或4期成人患者进行了回顾性病历审查。在预先指定的时间点提取了医疗利用率和结果信息：78例患者符合标准（113例住院；27例FP；51例NFP）。平均住院时间（LOS）为 122 天；FP 的 LOS 明显高于 NFP（P = 0.01）。平均咨询次数为 24 次。每次住院的估计费用为 175,198 美元。30 天内再入院率为 12.39%。出院后 1 年内的死亡率，NFP 为 21.57%，而 FP 组为 3.70%。只有 5.00% 的 NFP 伤口在出院时愈合，并在 1 年后持续愈合，明显低于 FP 伤口（55.26%，P 结论）：尽管在医疗保健使用方面的投资很高，但伤口愈合的效果却很差。此外，近 22% 的 NFP 在出院后一年内死亡。从伤口治疗效果、医疗成本和患者发病率/死亡率方面来看，SCI/D 患者因 PI 而长期住院的效用值得怀疑。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Luminescence 物理-光学

CiteScore

6.70

自引率

13.90%

发文量

850

审稿时长

3.8 months

期刊介绍： The purpose of the Journal of Luminescence is to provide a means of communication between scientists in different disciplines who share a common interest in the electronic excited states of molecular, ionic and covalent systems, whether crystalline, amorphous, or liquid. We invite original papers and reviews on such subjects as: exciton and polariton dynamics, dynamics of localized excited states, energy and charge transport in ordered and disordered systems, radiative and non-radiative recombination, relaxation processes, vibronic interactions in electronic excited states, photochemistry in condensed systems, excited state resonance, double resonance, spin dynamics, selective excitation spectroscopy, hole burning, coherent processes in excited states, (e.g. coherent optical transients, photon echoes, transient gratings), multiphoton processes, optical bistability, photochromism, and new techniques for the study of excited states. This list is not intended to be exhaustive. Papers in the traditional areas of optical spectroscopy (absorption, MCD, luminescence, Raman scattering) are welcome. Papers on applications (phosphors, scintillators, electro- and cathodo-luminescence, radiography, bioimaging, solar energy, energy conversion, etc.) are also welcome if they present results of scientific, rather than only technological interest. However, papers containing purely theoretical results, not related to phenomena in the excited states, as well as papers using luminescence spectroscopy to perform routine analytical chemistry or biochemistry procedures, are outside the scope of the journal. Some exceptions will be possible at the discretion of the editors.