Neurology:急性卒中后再次住院入住另一家医院与预后较差相关

2019-10-20 xing.T MedSci原创

由此可见,AIS30天内再次入院但入住另一家医院与入住同一家医院院相比,住院时间较长,总费用增加,并且住院死亡率更高。

急性缺血性卒中(AIS)在30天内再次住院的风险较高,但对入住另一家医院对再次住院的影响尚不清楚。近日,神经病学领域权威取杂志Neurology上发表了一篇研究文章,研究人员进行了一项回顾性队列研究,以评估这一假设,即AIS入院后30天再次入住另一医院的结局比入住上一次出院医院要更差。

研究人员利用2013年全国再入院数据库来确定通过ICD-9-CM代码明确的卒中入院患者,并使用临床分类软件确定了所有原因的再次入院。患者结局包括住院天数(LOS)、住院总费用以及再入院30天期间的住院死亡率。研究人员采用线性和Logistic回归分析,比较了再次住院入住另一个医院与另一个医院的患者结局。

该研究共纳入194549例患者,平均年龄为80.0±14.0岁。女性为51.2%;在30天内再次入院的患者有24545人,有7274人(占29.6%)的患者再次入住与上次出院不一样的医院。再次住院但入住另一家医院与LOS增加1.0天(95%置信区间[CI]为0.7–1.2,p<0.0001)和总费用增加$7677.28(95%CI为$5496–$9858,p<0.0001)相关。再次入院入住另一家医院时的住院死亡率的比值比为1.2(95%CI 1.0–1.3,p=0.0079)。

由此可见,AIS30天内再次入院但入住另一家医院与入住同一家医院院相比,住院时间较长,总费用增加,并且住院死亡率更高。 

原始出处:

Laura K. Stein,et al.Readmission to a different hospital following acute stroke is associated with worse outcomes.Neurology.2019.https://doi.org/10.1212/WNL.0000000000008446

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1671380, encodeId=eba116e1380ca, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Mon Mar 02 10:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2000889, encodeId=5ca6200088919, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Aug 29 02:07:00 CST 2020, time=2020-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1284460, encodeId=5f1e128446034, content=<a href='/topic/show?id=d2155222281' target=_blank style='color:#2F92EE;'>#急性卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52222, encryptionId=d2155222281, topicName=急性卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=afa4194, createdName=cenghis, createdTime=Tue Oct 22 03:07:00 CST 2019, time=2019-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026477, encodeId=0a2610264e7a8, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Sun Oct 20 15:07:00 CST 2019, time=2019-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374143, encodeId=abf63e41438a, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bbc11488193, createdName=thm112988, createdTime=Sun Oct 20 14:04:57 CST 2019, time=2019-10-20, status=1, ipAttribution=)]
    2020-08-29 yinhl1978
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  4. [GetPortalCommentsPageByObjectIdResponse(id=1671380, encodeId=eba116e1380ca, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Mon Mar 02 10:07:00 CST 2020, time=2020-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2000889, encodeId=5ca6200088919, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Aug 29 02:07:00 CST 2020, time=2020-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1284460, encodeId=5f1e128446034, content=<a href='/topic/show?id=d2155222281' target=_blank style='color:#2F92EE;'>#急性卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52222, encryptionId=d2155222281, topicName=急性卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=afa4194, createdName=cenghis, createdTime=Tue Oct 22 03:07:00 CST 2019, time=2019-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026477, encodeId=0a2610264e7a8, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Sun Oct 20 15:07:00 CST 2019, time=2019-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374143, encodeId=abf63e41438a, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bbc11488193, createdName=thm112988, createdTime=Sun Oct 20 14:04:57 CST 2019, time=2019-10-20, status=1, ipAttribution=)]
    2019-10-20 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

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    2019-10-20 thm112988

    0