BMC Cardiovasc Disord:中国急性心梗患者住院时间10年缩短3天(China-PEACE研究)

2015-02-17 Li Q 中国循环杂志

Year-trend Whisker plot of length of stay据估算到2020年将会有1600万,2030年有2300万急性心肌梗死患者来袭,那么到时候医院的床位够用吗? 近期阜外学者蒋立新等进行的China-PEACE研究的一项分析表明,2011年没有严重并发症的急性心梗患者住院时间为11天,较2001年缩短近3天,但与发达国家差距仍较大。 研究者认为,改善急性心

Year-trend Whisker plot of length of stay

据估算到2020年将会有1600万,2030年有2300万急性心肌梗死患者来袭,那么到时候医院的床位够用吗?

近期阜外学者蒋立新等进行的China-PEACE研究的一项分析表明,2011年没有严重并发症的急性心梗患者住院时间为11天,较2001年缩短近3天,但与发达国家差距仍较大。

研究者认为,改善急性心梗患者住院救护、院外康复、随访等环节,以及保险制度等对合理缩短住院时间,有效利用医疗资源很必要。

很多人认为,心梗了住院时间长点是好事。但研究者指出,延长住院时间并无意义,除了造成医疗资源的浪费和患者成本的增加外,患者还可能暴露于院内感染、深静脉血栓、肺栓塞以及医疗失误等风险中。

作者也认为,中国的医生可能担忧患者在出院后发生并发症,害怕患者或家属找麻烦,因此倾向于保守。

在西方发达国家,急性心梗患者平均住院时间为3~8天。当然也有例外,日本则是比较奇葩的国家,急性心梗的住院时间达到17~20天。

而在该项研究显示,中国急性心梗患者加权后平均住院时间在2001年为14.6天,2006年为12.6天,2011年为11.9天。可以看到,虽然十年来有所改进,但与西方发达国家差距仍较大。

此外,参与研究的不同地区、不同级别的160家医院差异也较大,急性心梗患者风险标准化后的住院时间波动在9.2~18.1天,其中中部地区医院较东部地区医院平均缩短了1.6天。

该研究共纳入2001、2006和2011年具有全国代表性的160家医院的16100位住院急性心肌梗死患者进行了分析。

原始出处:

Li Q, Lin Z, Masoudi FA,et al. National trends in hospital length of stay for acute myocardial infarction in China. BMC Cardiovasc Disord, 2015,15:9.
下载:PDF (484KB)

Li J, Li X, Wang Q, Hu S, Wang Y, Masoudi FA, Spertus JA, Krumholz HM, Jiang L; for the ChinaPEACE Collaborative Group.ST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data. Lancet. 2014 Jun 23. pii: S0140-6736(14)60921-1

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    2015-11-14 quxin068
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    2015-06-03 cmsvly
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    2015-06-07 drwjr
  4. 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topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Sat Dec 12 21:06:00 CST 2015, time=2015-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1655716, encodeId=6e931655e1608, content=<a href='/topic/show?id=2a011829d7' target=_blank style='color:#2F92EE;'>#ACE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1829, encryptionId=2a011829d7, topicName=ACE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=635024767990, createdName=shanyongle, createdTime=Sat Feb 21 18:06:00 CST 2015, time=2015-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725756, encodeId=3a461e2575611, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, 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GetPortalCommentsPageByObjectIdResponse(id=2049451, encodeId=9d94204945167, content=<a href='/topic/show?id=5c2e5106290' target=_blank style='color:#2F92EE;'>#心梗患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51062, encryptionId=5c2e5106290, topicName=心梗患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Fri Sep 18 17:06:00 CST 2015, time=2015-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1308323, encodeId=9c98130832381, content=<a href='/topic/show?id=8323522e503' target=_blank style='color:#2F92EE;'>#急性心梗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52275, encryptionId=8323522e503, topicName=急性心梗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fa4f352, createdName=chenlianhui, createdTime=Thu Feb 19 13:06:00 CST 2015, time=2015-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407116, encodeId=29b4140e116e4, content=<a href='/topic/show?id=d0db264464a' target=_blank style='color:#2F92EE;'>#住院时间#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26446, encryptionId=d0db264464a, topicName=住院时间)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bfbf2593024, createdName=crystal0563, createdTime=Thu Feb 19 13:06:00 CST 2015, time=2015-02-19, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1938463, encodeId=67821938463f1, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sat Nov 14 19:06:00 CST 2015, time=2015-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1784377, encodeId=30321e8437781, content=<a href='/topic/show?id=a727600194' target=_blank style='color:#2F92EE;'>#Disord#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6001, encryptionId=a727600194, topicName=Disord)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aad0444, createdName=cmsvly, createdTime=Wed Jun 03 02:06:00 CST 2015, time=2015-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008102, encodeId=96f620081021b, content=<a href='/topic/show?id=f244465139' target=_blank style='color:#2F92EE;'>#CHINA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4651, encryptionId=f244465139, topicName=CHINA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=08e964, createdName=drwjr, createdTime=Sun Jun 07 10:06:00 CST 2015, time=2015-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2011952, encodeId=2b8c201195252, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, 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likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Mon Jun 01 11:06:00 CST 2015, time=2015-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1974596, encodeId=4bc719e4596ba, content=<a href='/topic/show?id=f145355379' target=_blank style='color:#2F92EE;'>#BMC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3553, encryptionId=f145355379, topicName=BMC)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Fri Jan 22 16:06:00 CST 2016, time=2016-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2049451, encodeId=9d94204945167, content=<a href='/topic/show?id=5c2e5106290' target=_blank style='color:#2F92EE;'>#心梗患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51062, encryptionId=5c2e5106290, topicName=心梗患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Fri Sep 18 17:06:00 CST 2015, time=2015-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1308323, encodeId=9c98130832381, content=<a href='/topic/show?id=8323522e503' target=_blank style='color:#2F92EE;'>#急性心梗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52275, encryptionId=8323522e503, topicName=急性心梗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fa4f352, createdName=chenlianhui, createdTime=Thu Feb 19 13:06:00 CST 2015, time=2015-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407116, encodeId=29b4140e116e4, content=<a href='/topic/show?id=d0db264464a' target=_blank style='color:#2F92EE;'>#住院时间#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26446, encryptionId=d0db264464a, topicName=住院时间)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bfbf2593024, createdName=crystal0563, createdTime=Thu Feb 19 13:06:00 CST 2015, time=2015-02-19, status=1, ipAttribution=)]
    2015-02-21 shanyongle
  6. [GetPortalCommentsPageByObjectIdResponse(id=1938463, encodeId=67821938463f1, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sat Nov 14 19:06:00 CST 2015, time=2015-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1784377, encodeId=30321e8437781, content=<a href='/topic/show?id=a727600194' target=_blank style='color:#2F92EE;'>#Disord#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6001, encryptionId=a727600194, topicName=Disord)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aad0444, 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likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Mon Jun 01 11:06:00 CST 2015, time=2015-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1974596, encodeId=4bc719e4596ba, content=<a href='/topic/show?id=f145355379' target=_blank style='color:#2F92EE;'>#BMC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3553, encryptionId=f145355379, topicName=BMC)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Fri Jan 22 16:06:00 CST 2016, time=2016-01-22, status=1, ipAttribution=), 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createdName=chenlianhui, createdTime=Thu Feb 19 13:06:00 CST 2015, time=2015-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407116, encodeId=29b4140e116e4, content=<a href='/topic/show?id=d0db264464a' target=_blank style='color:#2F92EE;'>#住院时间#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26446, encryptionId=d0db264464a, topicName=住院时间)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bfbf2593024, createdName=crystal0563, createdTime=Thu Feb 19 13:06:00 CST 2015, time=2015-02-19, status=1, ipAttribution=)]
    2015-06-01 feather89
  7. 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据世界银行估计,至2030 年中国罹患心肌梗死(以下简称“心梗”)的人数将达2300 万。那么面对这么庞大的患者群,我国医疗体系应对是否得力?在最近十年间我国急性心梗诊疗模式如何?常用临床救治技术是否规范?患者从诊疗中获益几何? 这些问题,8日阜外心血管病医院蒋立新教授报告的“冠心病医疗结果评价和临床转化研究(China PEACE)研究”作了回答。  

Circ Cardiovasc Genet:首次心梗临床新生物标记物病例对照分析---特隆姆瑟研究(Tromsø Study)

传统心血管危险因素,包括年龄,性别,血压,总胆固醇,高密度脂蛋白胆固醇,吸烟状况,10年风险评估(无论心血管死亡率还是事件发生率)。然而,传统风险因素并不能充分反映心血管风险,特别是在大多数人经历第一次心血管事件,少于2个传统危险因素,被认为是低风险的患者中。传统风险因素的利弊刺激着对更多生物标记物的研究,被用在提高目前心血管疾病风险模型,能够预测心血管事件风险,改善传统预测模型,为更好的治疗

JACC:血小板活化或促社区获得性肺炎患者发生心梗

意大利一项研究表明,血小板活化为社区获得性肺炎(CAP)和心梗的相关性机制,但单独应用阿司匹林可能不足以降低心梗风险。论文11月4日在线发表于《美国心脏病学会杂志》(J Am Coll Cardiol)。 此项研究共纳入278例CAP住院患者并随访至患者出院,其中144例患者hs-cTnT水平升高(>0.014 µg/L)。大部分患者为孤立性hs-cTnT升高,31例患者则伴有急性