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[西班牙两家地区医院的居家新冠疫情管理。其意义、我们护理的对象、死亡人员以及援助随时间的演变情况]

[Management of COVID-19 pandemic in hospital at home in two regional Spanish hospitals. what it meant, who we cared for, who died and how assistance has evolved over time].

作者信息

Sánchez Fabra D, Herrero Jordán T, Alda Lozano A, Duro Suárez V, Saura Blasco N, Torres Courchoud I

机构信息

David Sánchez Fabra.C/ San Rafael 42, 3ºB, Zaragoza (50017) Spain.

出版信息

Rev Esp Quimioter. 2023 Aug;36(4):392-399. doi: 10.37201/req/138.2022. Epub 2023 May 3.

Abstract

OBJECTIVE

Home Hospitalization (HH) is an alternative hospitalization modality that can be very useful in times of health stress such as the COVID-19 pandemic. This paper includes the management of patients admitted with COVID-19 in HH in two county spanish hospitals for two years.

METHODS

A descriptive, observational and retrospective study of all patients admitted at HH with a diagnosis of COVID-19 disease was carried out. Subsequently, further analysis was carried out to characterize the patients who died in HH or 30 days after discharge and another to compare the management between the first phase of the study (2020) and the second one (2021 and part of 2022).

RESULTS

A total of 167 patients were recruited. A 52.1% moved to watch that the recovery continued compared to 40.7% in which it was done to watch that they did not worsen. The patients who died in HAD were older (mean 87.5 years), more comorbid and more likely to have do-not resucitate orders (DNR) in case of cardiac arrest (85%). In the second phase of the study, older patients, more comorbid patients and with a greater degree of DNR orders were admitted than those admitted throughout 2020.

CONCLUSIONS

HAD is a useful resource to increase the resilience of health systems in cases of stress such as the disease caused by COVID-19. The development and growth of existing units, as well as the creation of new ones where they do not exist, could be a basic tool for the medicine of the future.

摘要

目的

居家住院(HH)是一种替代住院模式,在诸如新冠疫情等健康压力时期可能非常有用。本文涵盖了西班牙两家县级医院两年来对因新冠病毒病入住居家住院的患者的管理情况。

方法

对所有诊断为新冠病毒病入住居家住院的患者进行了描述性、观察性和回顾性研究。随后,进一步分析以描述在居家住院期间或出院后30天内死亡的患者特征,并另作分析以比较研究第一阶段(2020年)和第二阶段(2021年及2022年部分时间)之间的管理情况。

结果

共招募了167名患者。52.1% 的患者转为观察其恢复情况是否持续,而40.7% 的患者转为观察其病情是否恶化。在居家住院中死亡的患者年龄更大(平均87.5岁),合并症更多,且在心脏骤停时更有可能有不要复苏医嘱(DNR)(85%)。在研究的第二阶段,与2020年全年收治的患者相比,收治的老年患者、合并症更多的患者以及有更高比例不要复苏医嘱的患者更多。

结论

居家住院是一种有用的资源,可在诸如新冠病毒病等压力情况下提高卫生系统的适应能力。现有单元的发展和扩充,以及在没有的地方创建新单元,可能是未来医学的一项基本工具。

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