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[RAE-CMBD用于研究流感住院患者的有效性和实用性]

[Validity and usefulness of the RAE-CMBD studying patients hospitalised with influenza].

作者信息

Quirós-González V, Bernal J L, Haro-Pérez A M, Maderuelo-Fernández J A, Santos-Jiménez M T, García-Barrio N, Pavón-Muñoz A L, López-Sánchez E, García-Iglesias M A, Serrano P, Eiros J M

机构信息

Víctor Quirós González, Dirección de Planificación, Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n, 28041 Madrid, Spain.

出版信息

Rev Esp Quimioter. 2023 Apr;36(2):160-168. doi: 10.37201/req/074.2022. Epub 2023 Jan 18.

Abstract

OBJECTIVE

Understanding the hospital impact of influenza requires enriching epidemiological surveillance registries with other sources of information. The aim of this study was to determine the validity of the Hospital Care Activity Record - Minimum Basic Data Set (RAE-CMBD) in the analysis of the outcomes of patients hospitalised with this infection.

METHODS

Observational and retrospective study of adults admitted with influenza in a tertiary hospital during the 2017/2018 and 2018/2019 seasons. We calculated the concordance of the RAE-CMBD with the influenza epidemiological surveillance registry (gold standard), as well as the main parameters of internal and external validity. Logistic regression models were used for risk adjustment of in-hospital mortality and length of stay.

RESULTS

A total of 907 (97.74%) unique matches were achieved, with high inter-observer agreement (ƙ=0.828). The RAE-CMBD showed a 79.87% sensitivity, 99.72% specificity, 86.71% positive predictive value and 99.54% negative predictive value. The risk-adjusted mortality ratio of patients with influenza was lower than that of patients without influenza: 0.667 (0.53-0.82) vs. 1.008 (0.98-1.04) and the risk-adjusted length of stay ratio was higher: 1.15 (1.12-1.18) vs. 1.00 (0.996-1.001).

CONCLUSIONS

The RAE-CMBD is a valid source of information for the study of the impact of influenza on hospital care. The lower risk-adjusted mortality of patients admitted with influenza compared to other inpatients seems to point to the effectiveness of the main clinical and organisational measures adopted.

摘要

目的

了解流感对医院的影响需要用其他信息来源丰富流行病学监测登记册。本研究的目的是确定医院护理活动记录-最低基本数据集(RAE-CMBD)在分析因该感染住院患者结局方面的有效性。

方法

对2017/2018年和2018/2019年季节在一家三级医院因流感入院的成年人进行观察性和回顾性研究。我们计算了RAE-CMBD与流感流行病学监测登记册(金标准)的一致性,以及内部和外部有效性的主要参数。使用逻辑回归模型对住院死亡率和住院时间进行风险调整。

结果

共实现了907次(97.74%)独特匹配,观察者间一致性较高(ƙ=0.828)。RAE-CMBD的灵敏度为79.87%,特异度为99.72%,阳性预测值为86.71%,阴性预测值为99.54%。流感患者的风险调整死亡率低于非流感患者:0.667(0.53-0.82)对1.008(0.98-1.04),风险调整住院时间比更高:1.15(1.12-1.18)对1.00(0.996-1.001)。

结论

RAE-CMBD是研究流感对医院护理影响的有效信息来源。与其他住院患者相比,因流感入院患者的风险调整死亡率较低,这似乎表明所采取的主要临床和组织措施是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1e4/10066910/c4e3aa6dd3e0/revespquimioter-36-160-g001.jpg

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