Department of Family Medicine, School of Medicine, Konkuk University, Seoul 05029, Republic of Korea.
Department of Preventive Medicine, School of Medicine, Konkuk University, Seoul 05029, Republic of Korea.
Int J Environ Res Public Health. 2023 Jan 31;20(3):2488. doi: 10.3390/ijerph20032488.
This study aimed to determine whether prehospital visits to other medical institutions before admission are associated with prolonged hospital stay, readmission, or mortality rates in acute stroke patients. Using the claims data from the Korean Health Insurance Service, a cross-sectional study was conducted on 58,418 newly diagnosed stroke patients aged ≥ 20 years from 1 January 2019 to 31 December 2019. Extended hospital stay (≥7 days; median value) following initial admission, readmission within 180 days after discharge, and all-cause mortality within 30 days were measured as health outcomes using multiple logistic regression analysis after adjusting for age, sex, income, residential area, and medical history. Stroke patients with a prehospital visit (10,992 patients, 18.8%) had a higher risk of long hospitalization (odds ratio = 1.06; 95% confidence interval = 1.02-1.10), readmission (1.19; 1.14-1.25), and mortality (1.23; 1.13-1.33) compared with patients without a prehospital visit. Female patients and those under 65 years of age had increased unfavorable outcomes ( < 0.05). Prehospital visits were associated with unfavorable health outcomes.
本研究旨在确定急性卒中患者在入院前是否曾前往其他医疗机构就诊与住院时间延长、再入院或死亡率相关。本研究使用韩国健康保险服务的索赔数据，对 2019 年 1 月 1 日至 2019 年 12 月 31 日期间 58418 名年龄≥20 岁的新发卒中患者进行了一项横断面研究。使用多变量逻辑回归分析，在校正年龄、性别、收入、居住地区和既往病史后，将初始入院后延长住院时间（≥7 天；中位数）、出院后 180 天内再入院和 30 天内全因死亡率作为健康结局进行测量。与未进行院前就诊的患者相比，有院前就诊（10992 例，18.8%）的卒中患者住院时间延长（比值比=1.06；95%置信区间=1.02-1.10）、再入院（1.19；1.14-1.25）和死亡率（1.23；1.13-1.33）的风险更高。女性患者和年龄<65 岁的患者发生不良结局的风险增加（<0.05）。院前就诊与不良健康结局相关。
