医生对颅脑损伤患者康复措施的选择-19

K. Lomonosov
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摘要

相关性。据世界卫生组织统计,2020 年 1 月至 2023 年 1 月期间,新感染冠状病毒的患者人数将超过 6.76 亿人。显而易见,COVID-19 的后果将在未来几年的医疗实践中普遍存在,因此在为冠状病毒感染患者提供医疗护理时,医疗康复应成为关注的焦点。调查医生为Covid-19患者选择康复干预措施的方法。对莫斯科一家临时冠状病毒医院 2020-2022 年收治的 1832 名患者的病历进行了分析。统计分析使用 StatTech v. 3.1.3 程序(由俄罗斯 Stattech LLC 公司开发)进行。使用逻辑回归法建立了表征康复措施遵守情况的预测模型。对具有统计学意义的回归模型的预测因素进行的分析表明,在决定患者出院后是否需要采取康复措施或进行额外诊治时,医生依赖的是患者在感染 COVID-19 病毒前已经存在的病理现象,而没有考虑到任何器官系统在新感染冠状病毒后可能出现的病理现象。例如,有心血管疾病或动脉粥样硬化病史的患者预约心脏科医生会诊的次数增加了 6 倍,同时有心血管疾病和动脉粥样硬化病史的患者预约心脏科医生会诊的次数增加了 10 倍。如果患有支气管哮喘,向肺科医生咨询的概率会增加近 3 倍;如果没有糖尿病,向内分泌科医生寻求额外建议的概率会降低 11 倍。个人康复计划应考虑到 COVID-19 疾病的严重程度、肺组织、心脏、血管和其他器官的损伤程度。回归模型可用于经济分析,以确定必要的工作时间和医务人员数量,从而确保新发冠状病毒感染患者的康复措施达到最佳数量和效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Doctors' Choice of Rehabilitation Measures for Patients Who Have Suffered Covid-19
Relevance. According to WHO, the number of patients with a new coronavirus infection amounted to more than 676 million people for the period from January 2020 to January 2023. It is obvious that the consequences of COVID-19 will prevail in medical practice in the coming years, so medical rehabilitation should be the focus of attention when providing medical care to patients with coronavirus infection.Aims. To investigate the approach to physicians' selection of rehabilitation interventions for patients who have undergone Covid-19.Materials and methods. The analysis of 1832 case histories of patients of one of the temporary covid hospitals in Moscow, who are being treated in the hospital in 2020–2022, was carried out. Statistical analysis was carried out using the StatTech v. 3.1.3 program (developed by Stattech LLC, Russia). Predictive models characterizing adherence to rehabilitation measures were developed using the logistic regression method.Results and discussions. The analysis of predictors of statistically significant regression models showed that when deciding on the appointment of rehabilitation measures or additional consultation when a patient is discharged from the hospital, doctors rely on pathologies already present in patients before COVID-19 disease, without taking into account the occurrence of possible pathology after a new coronavirus infection in any organ system. For example, the appointment of a cardiologist's consultation increases 6 times in the presence of a history of cardiovascular diseases or atherosclerosis and 10 times in the presence of cardiovascular diseases and atherosclerosis at the same time. The presence of bronchial asthma increased the probability of consulting a pulmonologist by almost 3 times, and in the absence of diabetes mellitus, the probability of getting additional advice from an endocrinologist decreased by 11 times.Conclusions. An individual rehabilitation plan should take into account the severity of the COVID-19 disease, the degree of damage to the lung tissue, heart, blood vessels and other organs. The regression models can be used for economic analysis in order to identify the need for working hours and the number of medical workers necessary to ensure the optimal volume and effectiveness of rehabilitation measures for patients who have suffered a new coronavirus infection.
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