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单中心儿科心脏病学病房因成人先天性心脏病患者增加而导致住院趋势的变化。

Changes of hospitalization trend in the pediatric cardiology division of a single center by increasing adult with congenital heart disease.

机构信息

Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.

Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.

出版信息

BMC Cardiovasc Disord. 2020 May 15;20(1):227. doi: 10.1186/s12872-020-01511-3.

Abstract

BACKGROUND

As a result of advances in pediatric care and diagnostic testing, there is a growing population of adults with congenital heart disease (ACHD). The purpose of this study was to better define the epidemiology and changes in the trend of hospitalizations for ACHD in Korean society.

METHODS

We reviewed outpatient and inpatient data from 2005 to 2017 to identify patient ≥18 years of age admitted for acute care with a congenital heart disease (CHD) diagnosis in the pediatric cardiology division. We tried to analyze changes of hospitalization trend for ACHD.

RESULTS

The ratio of outpatients with ACHD increased 286.5%, from 11.1% (1748/15,682) in 2005 to 31.8% (7795/24,532) in 2017. The number of ACHD hospitalizations increased 360.7%, from 8.9% (37/414) in 2005 to 32.1% (226/705) in 2017. The average patient age increased from 24.3 years in 2005 to 27.4 in 2017. The main diagnosis for admission of ACHD is heart failure, arrhythmia and Fontan-related complications. The annual ICU admission percentage was around 5% and mean length of intensive care unit (ICU) stay was 8.4 ± 14.6 days. Mean personal hospital charges by admission of ACHD increased to around two times from 2005 to 2017. (from $2578.1 to $3697.0). Total annual hospital charges by ACHD markedly increased ten times (from $95,389.7 to $831,834.2).

CONCLUSIONS

The number of hospital cares for ACHD dramatically increased more than five times from 2005 to 2017. We need preparations for efficient healthcare for adults with CHD such as a multi-dimensional approach, effective communication, and professional training.

摘要

背景

由于儿科护理和诊断测试的进步,患有先天性心脏病 (ACHD) 的成年人数量不断增加。本研究旨在更好地定义韩国社会 ACHD 的流行病学和住院趋势变化。

方法

我们回顾了 2005 年至 2017 年的门诊和住院数据,以确定在儿科心脏病学部门因急性护理入院的年龄≥18 岁且患有先天性心脏病 (CHD) 诊断的患者。我们试图分析 ACHD 住院趋势的变化。

结果

ACHD 门诊患者的比例从 2005 年的 11.1%(1748/15682)增加到 2017 年的 31.8%(7795/24532),增加了 286.5%。ACHD 住院人数增加了 360.7%,从 2005 年的 8.9%(37/414)增加到 2017 年的 32.1%(226/705)。患者平均年龄从 2005 年的 24.3 岁增加到 2017 年的 27.4 岁。ACHD 入院的主要诊断是心力衰竭、心律失常和 Fontan 相关并发症。每年 ICU 入院率约为 5%,平均 ICU 住院时间为 8.4±14.6 天。ACHD 入院的个人住院费用从 2005 年到 2017 年增加到约两倍。(从 2578.1 美元增加到 3697.0 美元)。ACHD 每年的总住院费用增加了十倍(从 95389.7 美元增加到 831834.2 美元)。

结论

从 2005 年到 2017 年,ACHD 的住院治疗次数增加了五倍以上。我们需要为 CHD 成年人做好高效医疗保健的准备,例如采取多维方法、有效沟通和专业培训。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6961/7229598/6f6c2b390558/12872_2020_1511_Fig1_HTML.jpg

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