Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University School of Medicine, Atlanta, GA.
Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA.
Ann Epidemiol. 2022 Aug;72:26-31. doi: 10.1016/j.annepidem.2022.05.001. Epub 2022 May 9.
To examine the hypothesis that longer distance from home-to-hospital is associated with worse outcomes among hospitalizations for community-acquired sepsis.
A secondary analysis of data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) prospective cohort of 30,239 white and Black US adults greater than or equal to 45 years old was conducted. Self-reported hospitalizations for serious infection between 2003 and 2012 fulfilling 2/4 systemic inflammatory response syndrome criteria were included. Estimated driving distance was derived from geocoded data and evaluated continuously and as quartiles of very close, close, far, very far (<3.1, 3.1-5.8, 5.9-11.5, and >11.5 miles respectively). The primary outcome was 30-day mortality while the secondary outcome was sequential organ failure assessment (SOFA) score on arrival.
Of the 912 hospitalizations for community-acquired sepsis had adequate data for analysis. The median (interquartile range) estimated driving distance was 5.8 miles (3.1,11.7), and 54 (5.9%) experienced the primary outcome. Compared to living very close, participants living very far had a mortality odds ratio of 1.30 (95% CI 0.64,2.62) and presenting SOFA score difference of 0.33 (95% CI -0.03,0.68).
Among a national sample of community-acquired sepsis hospitalizations, there was no significant association between home-to-hospital distance and either 30-day mortality or SOFA score on hospital presentation.
检验这样一个假设，即居住地到医院的距离越远，与社区获得性败血症住院患者的预后越差之间存在关联。
对“美国地理和种族差异中风原因（REGARDS）”前瞻性队列中 30239 名白人和黑人年龄大于或等于 45 岁的成年人的数据进行二次分析。纳入 2003 年至 2012 年间自我报告的符合 2/4 全身炎症反应综合征标准的严重感染住院治疗病例。通过地理编码数据估计驾驶距离，并连续评估和分为四个四分位数的非常近、近、远、非常远（分别为<3.1、3.1-5.8、5.9-11.5 和>11.5 英里）。主要结局是 30 天死亡率，次要结局是入院时的序贯器官衰竭评估（SOFA）评分。
在 912 例社区获得性败血症住院患者中，有足够数据进行分析。估计驾驶距离的中位数（四分位距）为 5.8 英里（3.1，11.7），54 例（5.9%）发生主要结局。与居住非常近的患者相比，居住非常远的患者的死亡率比值比为 1.30（95%CI 0.64，2.62），入院时的 SOFA 评分差值为 0.33（95%CI-0.03，0.68）。
在全国性社区获得性败血症住院患者样本中，居住地到医院的距离与 30 天死亡率或入院时 SOFA 评分之间没有显著关联。
