PLOS ONE:周末和夜间就诊的心梗患者病情重,死亡率高

2017-04-12 卢芳 中国循环杂志

在上世纪70年代,就有学者发现了“周末效应”,所谓的周末效应就是指非工作时间入院死亡风险增加。近期中国医学科学院阜外医院高润霖院士和北京大学公共卫生学院、乔治全球健康研究院武阳丰教授等在全国99家二级医院进行的研究也证实,周末和夜间就诊的ST段抬高型心肌梗死(STEMI)患者死亡率会增加1.3%,但校正混淆因素后,没有统计学差异。研究显示,在工作时间入院的STEMI患者死亡率为7.0%,而非正式工

在上世纪70年代,就有学者发现了“周末效应”,所谓的周末效应就是指非工作时间入院死亡风险增加。

近期中国医学科学院阜外医院高润霖院士和北京大学公共卫生学院、乔治全球健康研究院武阳丰教授等在全国99家二级医院进行的研究也证实,周末和夜间就诊的ST段抬高型心肌梗死(STEMI)患者死亡率会增加1.3%,但校正混淆因素后,没有统计学差异。

研究显示,在工作时间入院的STEMI患者死亡率为7.0%,而非正式工作时间入院死亡率则上升到8.3%。

其中,周末和夜间就诊的患者病情较重可解释55%死亡差异,治疗可解释20%的死亡差异。比如非正常工作时间入院患者的二级预防用药比例略低,但溶栓比例较高(43.1% vs 34.8%)。整体上也就只有35%~43%接受了溶栓。

该研究还显示,心梗患者从发病到入院的平均时间为4小时,这意味着绝大多数患者在发病后3小时未能接受溶栓治疗。

研究者强调,目前仍需加强科普教育,让公众了解心梗早期症状,加强及时就医的观念。

该研究数据均来自CPACS-3研究。研究者在全国15个省市99家不具备PCI条件的二级医院中共纳入7456例STEMI患者,其中有45.2%的患者在正常工作时间入院(周一到周五的早八点到晚五点),54.8%在周末或下班后非工作时间入院。两组患者均约有17%转至三级医院。

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    2017-04-14 flysky120

    夜间心肌梗塞患者多

    0

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    2017-04-13 186****0580(小山羊)

    学习了谢谢了。

    0

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    2017-04-13 wen2009

    确实如此

    0

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