影响肺栓塞住院时间的因素。一项队列研究。

Factors Influencing Hospital Stay for Pulmonary Embolism. A Cohort Study.

机构信息

Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España.

Departamento de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, España; CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, España; Grupo de Epidemiología, Salud Pública y Evaluación de Servicios de Salud, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España.

出版信息

Arch Bronconeumol. 2017 Aug;53(8):432-436. doi: 10.1016/j.arbres.2017.01.003. Epub 2017 Feb 24.

DOI:10.1016/j.arbres.2017.01.003

PMID:28238515

Abstract

INTRODUCTION

The aim of this study was to identify factors influencing hospital stay due to pulmonary embolism.

METHODS

We performed a retrospective cohort study of patients hospitalized between 2010 and 2015. Patients were identified using information recorded in hospital discharge reports (ICD-9-CM codes 415.11 and 415.19).

RESULTS

We included 965 patients with a median stay of 8 days (IQR 6-13 days). Higher scores on the simplified Pulmonary Embolism Severity Index (sPESI) were associated with increased probability of longer hospital stay. The probability of a hospital stay longer than the median was 8.65 (95% CI 5.42-13.79) for patients referred to the Internal Medicine Department and 1.54 (95% CI 1.07-2.24) for patients hospitalized in other departments, compared to those referred to the Pneumology Department. Patients with grade 3 on the modified Medical Research Council dyspnea scale had an odds ratio of 1.63 (95% CI: 1.07-2.49). The likelihood of a longer than median hospital stay was 1.72 (95% CI: 0.85-3.48) when oral anticoagulation (OAC) was initiated 2-3 days after admission, and 2.43 (95% CI: 1.16-5.07) when initiated at 4-5 days, compared to OAC initiation at 0-1 days.

CONCLUSIONS

sPESI grade, the department of referral from the Emergency Department, the grade of dyspnea and the time of initiating OAC were associated with a longer hospital stay.

摘要

简介

本研究旨在确定影响肺栓塞住院时间的因素。

方法

我们对 2010 年至 2015 年期间住院的患者进行了回顾性队列研究。使用医院出院报告中记录的信息（ICD-9-CM 代码 415.11 和 415.19）识别患者。

结果

共纳入 965 例患者，中位住院时间为 8 天（IQR 6-13 天）。简化的肺栓塞严重程度指数（sPESI）评分较高与住院时间延长的可能性增加相关。与呼吸内科就诊的患者相比，内科就诊患者的住院时间长于中位数的可能性为 8.65（95%CI 5.42-13.79），而其他科室就诊患者为 1.54（95%CI 1.07-2.24）。改良的医学研究委员会呼吸困难量表 3 级患者的优势比为 1.63（95%CI：1.07-2.49）。与入院后 0-1 天开始口服抗凝治疗（OAC）相比，入院后 2-3 天开始 OAC 的患者的住院时间长于中位数的可能性为 1.72（95%CI：0.85-3.48），而入院后 4-5 天开始 OAC 的患者的可能性为 2.43（95%CI：1.16-5.07）。