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直接经皮冠状动脉介入治疗后急性心肌梗死患者住院时间的相关因素。

The factors related to hospitalization period in patients with acute myocardial infarction treated after primary percutaneous coronary intervention.

作者信息

Mirbolouk Fardin, Salari Arsalan, Gholipour Mahboobeh, Nikfarjam Salman, Pourbahador Reza, Mohamadnia Hamideh, Akbari-Parsa Niloufar

机构信息

Associate Professor, Cardiovascular Diseases Research Center AND Heshmat Hospital, Department of Cardiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Assistant Professor, Cardiovascular Diseases Research Center AND Heshmat Hospital, Department of Cardiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

ARYA Atheroscler. 2020 May;16(3):115-122. doi: 10.22122/arya.v16i3.1915.

Abstract

BACKGROUND

Decreasing the hospital length of stay (LOS) in ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PPCI) is an issue which is related to reducing hospital costs. This study was aimed to determine the average number of hospital LOS among patients with STEMI treated by PPCI and predictors of longer LOS.

METHODS

This cross-sectional study was performed on 561 patients with STEMI who referred to Heshmat Hospital, Rasht, north of Iran, within 2015-2018. As soon as STEMI was detected, patients were transferred to the catheterization laboratory (cath lab) in the shortest possible time and underwent PPCI. A questionnaire including characteristics of patients, procedures, and in-hospital adverse events was completed. Data were analyzed with SPSS software.

RESULTS

The mean age of patients was 59.36 ± 11.90 years. 74.2% (n = 416) of subjects were men and 25.8% (n = 145) were women. The hospital LOS of 3 to 6 days had the highest prevalence up to 47%. The results of the multiple logistic regression showed that risk of hospital LOS > 6 days in unsuccessful percutaneous coronary intervention (PCI) was 33.2 versus 66.8 in successful PCI (P = 0.001). Moreover, the risk of hospital LOS > 6 days in subjects who had post-procedure complication, problems at admission, and primary comorbidities was 9.13 (7.22-11.53)-fold, 4.09 (2.86-5.85)-fold, and 1.75 (1.35-2.27)-fold more than those who had not, respectively.

CONCLUSION

By identifying controllable predictive factors associated with prolonged hospitalization after PPCI, the length of hospitalization can be decreased; also, the patient remission can be enhanced and hospital costs reduced.

摘要

背景

缩短ST段抬高型心肌梗死(STEMI)患者在接受直接经皮冠状动脉介入治疗(PPCI)后的住院时间(LOS)是一个与降低医院成本相关的问题。本研究旨在确定接受PPCI治疗的STEMI患者的平均住院天数以及住院时间延长的预测因素。

方法

本横断面研究对2015年至2018年期间转诊至伊朗北部拉什特市赫什马特医院的561例STEMI患者进行。一旦检测到STEMI,患者尽快被转至导管室并接受PPCI。完成一份包括患者特征、手术过程和院内不良事件的问卷。数据用SPSS软件进行分析。

结果

患者的平均年龄为59.36±11.90岁。74.2%(n = 416)的受试者为男性,25.8%(n = 145)为女性。住院3至6天的发生率最高,达47%。多元逻辑回归结果显示,经皮冠状动脉介入治疗(PCI)未成功患者住院时间>6天的风险为33.2,而PCI成功患者为66.8(P = 0.001)。此外,术后有并发症、入院时有问题和有原发性合并症的受试者住院时间>6天的风险分别比没有这些情况的受试者高9.13(7.22 - 11.53)倍、4.09(2.86 - 5.85)倍和1.75(1.35 - 2.27)倍。

结论

通过识别与PPCI后住院时间延长相关的可控预测因素,可以缩短住院时间;同时,可提高患者缓解率并降低医院成本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfb4/7778514/7d91d8d4b50a/ARYA-16-115f1.jpg

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