Rajendran Nithya, Rameli Puteri Maisarah, Malomo Keneilwe, Byrne Declan, Browne Joseph, Ntlholang Ontefetse
Department of General Internal Medicine, St. James's Hospital, James's Street, D08 NHY1 Dublin, Ireland.
Department of Geriatrics and General Internal Medicine, St. James's Hospital, James's Street, D08 NHY1 Dublin, Ireland.
Healthcare (Basel). 2023 Feb 20;11(4):627. doi: 10.3390/healthcare11040627.
Our study aimed to analyse delaying factors amongst patients with a length of stay (LOS) > 15 days during the COVID-19 pandemic using time-to-event analysis. A total of 390 patients were admitted between March 2020-February 2021 to the subacute complex discharge unit in St James's Hospital: 326 (83.6%) were >65 years of age and 233 (59.7%) were female. The median (IQR) age was 79 (70-86) years with a median (IQR) of 19.4 (10-41) days. A total of 237 (60.7%) events were uncensored, with LOS > 15 days, of which 138 (58.2%) were female and 124 (52.32%) had >4 comorbidities; 153 (39.2%) were censored into LOS ≤ 15 days, and death occurred in 19 (4.8%). Kaplan-Meier's plot compared factors causing a delay in discharge to the single factors: age, gender, and multimorbidity. A multivariate Cox regression analysis adjusted to age, gender, and multimorbidity predicted factors affecting LOS. Further research is required to explore multimorbidity as a risk factor for mortality in patients with prolonged LOS within a complex discharge unit and target gender-specific frailty measures to achieve high-quality patient management.
我们的研究旨在使用事件发生时间分析，剖析在新冠疫情期间住院时间（LOS）>15天的患者中的延迟因素。2020年3月至2021年2月期间，共有390名患者被收治入圣詹姆斯医院的亚急性综合出院单元：326名（83.6%）年龄>65岁，233名（59.7%）为女性。年龄中位数（四分位间距）为79（70 - 86）岁，住院时间中位数（四分位间距）为19.4（10 - 41）天。共有237例（60.7%）事件未被删失，住院时间>15天，其中138例（58.2%）为女性，124例（52.32%）有>4种合并症；153例（39.2%）被删失为住院时间≤15天，19例（4.8%）死亡。Kaplan - Meier曲线将导致出院延迟的因素与单一因素（年龄、性别和多种合并症）进行了比较。多变量Cox回归分析对年龄、性别和多种合并症进行了校正，预测了影响住院时间的因素。需要进一步研究，以探索多种合并症作为复杂出院单元中住院时间延长患者死亡的危险因素，并针对特定性别的虚弱措施，以实现高质量的患者管理。
