探讨“周末效应”对左心室辅助装置患者护理的影响

Gbolahan O. Ogunbayo, L. Ha, N. Misumida, A. Elbadawi, Q. Ahmad, Remi T. Okwechime, D. Akanya, A. Kolodziej, C. Elayi, M. Guglin
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引用次数: 0

摘要

许多研究已经描述了在工作日和周末治疗主要心脏病的患者在住院结果和住院时间上的差异本研究旨在探讨“周末效应”对使用左心室辅助装置患者住院护理的影响。方法使用来自国家住院患者样本(NIS)数据库的数据,加权估计每年超过3500万人次我们确定了18岁或18岁以上的患者,ICD代码表示LVAD的存在。比较了周末和工作日入院的患者的特征、合并症和临床结果。关注的结局是院内全因死亡率和住院时间(LOS)。结果周末入院的患者年龄较小,其他两组在合并症方面相似。周末入院的患者更容易发生心源性休克、感染性休克和呼吸衰竭。他们也更有可能需要机械通气和进行心脏移植。然而,在周末入院的患者的平均住院时间较短。多变量分析后,这一结果仍然显著(OR .81, 95% CI .72-)。91年,p < 0.01)。我们对这个大型数据库的数据分析表明,周末入院对lvad患者的全因死亡率没有影响,尽管周末入院的患者更有可能缩短住院时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Exploring the “Weekend Effect” on the Care of Patients with Left Ventricular Assist Devices
Background Many studies have described differences in in-hospital outcomes and length of stay between patients treated for major cardiac conditions on weekdays versus weekends.1 Our study aimed to explore the “weekend effect” on in-hospital care among patients with left ventricular assist devices. Methods Using data from the National Inpatient Sample (NIS) database, with a weighted estimate of more than 35 million admissions per year.2 We identified patients 18 years or older with an ICD code signifying presence of a LVAD. Characteristics, comorbidities and clinical outcomes were compared between patients admitted on a weekend versus patients admitted on a weekday. The outcomes of interest were in-hospital all-cause mortality and length of hospital stay (LOS). Results Patients admitted on weekend days were younger, otherwise both groups were similar with respect to comorbidities. Patients admitted on weekend days were more likely to have cardiogenic shock, septic shock and respiratory failure. They were also more likely to require mechanical ventilation and undergo cardiac transplantation. Patients admitted on a weekend day however had a shorter hospital median hospital stay. This remained significant after multivariate analysis (OR .81 95% CI .72-.91, p<0.01). Our data analysis from this large database demonstrates no effect of weekend admission on all-cause mortality among patients with LVADs, although patients admitted on weekend days were more likely to have shorter hospital stay.
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