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急性病成年患者的新型院前表型和结局。

Novel Prehospital Phenotypes and Outcomes in Adult-Patients with Acute Disease.

机构信息

Advanced Clinical Simulation Center. Faculty of Medicine, Valladolid University, Valladolid, Spain.

Advanced Life Support, Emergency Medical Services (SACYL), Valladolid, Spain.

出版信息

J Med Syst. 2022 May 21;46(7):45. doi: 10.1007/s10916-022-01825-z.

Abstract

An early identification of prehospital phenotypes may allow health care workers to speed up and improve patients' treatment. To determine emergency phenotypes by exclusively using prehospital clinical data, a multicenter, prospective, and observational ambulance-based study was conducted with a cohort of 3,853 adult patients treated consecutively and transferred with high priority from the scene to the hospital emergency department. Cluster analysis determined three clusters with highly different outcome scores and pathological characteristics. The first cluster presented a 30-day mortality after the index event of 45.9%. The second cluster presented a mortality of 26.3%, while mortality of the third cluster was 5.1%. This study supports the detection of three phenotypes with different risk stages and with different clinical, therapeutic, and prognostic considerations. This evidence could allow adapting treatment to each phenotype thereby helping in the decision-making process.

摘要

早期识别院前表型可能使医护人员能够加快并改善患者的治疗效果。为了仅使用院前临床数据确定急救表型,对连续治疗并以高优先级从现场转移到医院急诊室的 3853 名成年患者进行了一项多中心、前瞻性、基于救护车的观察性研究。聚类分析确定了三个具有高度不同结局评分和病理特征的聚类。第一个聚类在指数事件后 30 天的死亡率为 45.9%。第二个聚类的死亡率为 26.3%,而第三个聚类的死亡率为 5.1%。本研究支持检测具有不同风险阶段的三种表型,以及具有不同临床、治疗和预后考虑的表型。这一证据可以使治疗适应每种表型,从而有助于决策过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9196/9123608/7453b7afb4b6/10916_2022_1825_Fig1_HTML.jpg

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