Suppr超能文献

急诊科收治的充血性心力衰竭患者诊断差异与住院时间和死亡率的关联

Association of Diagnostic Discrepancy with Length of Stay and Mortality in Congestive Heart Failure Patients Admitted to the Emergency Department.

作者信息

Finkelstein Joseph, Cui Wanting, Ferraro Jeffrey P, Kawamoto Kensaku

机构信息

Department of Biomedical Informatics, School of Medicine, University of Utah, Salt Lake City, UT.

Department of Medicine, School of Medicine, University of Utah, Salt Lake City, UT.

出版信息

AMIA Jt Summits Transl Sci Proc. 2024 May 31;2024:155-161. eCollection 2024.

Abstract

The goal of this study was to analyze diagnostic discrepancies between emergency department (ED) and hospital discharge diagnoses in patients with congestive heart failure admitted to the ED. Using a synthetic dataset from the Department of Veterans Affairs, the patients' primary diagnoses were compared at two levels: diagnostic category and body system. With 12,621 patients and 24,235 admission cases, the study found a 58% mismatch rate at the category level, which was reduced to 30% at the body system level. Diagnostic categories associated with higher levels of mismatch included aplastic anemia, pneumonia, and bacterial infections. In contrast, diagnostic categories associated with lower levels of mismatch included alcohol-related disorders, COVID-19, cardiac dysrhythmias, and gastrointestinal hemorrhage. Further investigation revealed that diagnostic mismatches are associated with longer hospital stays and higher mortality rates. These findings highlight the importance of reducing diagnostic uncertainty, particularly in specific diagnostic categories and body systems, to improve patient care following ED admission.

摘要

本研究的目的是分析急诊科(ED)收治的充血性心力衰竭患者中,急诊科诊断与医院出院诊断之间的差异。利用退伍军人事务部的合成数据集,在两个层面比较了患者的主要诊断:诊断类别和身体系统。该研究纳入了12621名患者和24235例入院病例,发现在类别层面的不匹配率为58%,在身体系统层面降至30%。与较高不匹配水平相关的诊断类别包括再生障碍性贫血、肺炎和细菌感染。相比之下,与较低不匹配水平相关的诊断类别包括酒精相关障碍、COVID-19、心律失常和胃肠道出血。进一步调查发现,诊断不匹配与更长的住院时间和更高的死亡率相关。这些发现凸显了减少诊断不确定性的重要性,特别是在特定的诊断类别和身体系统中,以改善急诊科收治后患者的护理。

相似文献

8
The effect of a short-stay unit on hospital admission and length of stay in acute heart failure: REDUCE-AHF study.
Eur J Intern Med. 2017 May;40:30-36. doi: 10.1016/j.ejim.2017.01.015. Epub 2017 Jan 23.
9
Intensive care unit admission from the emergency department in the setting of National Emergency Access Targets.
Crit Care Resusc. 2023 Jun 30;25(2):84-89. doi: 10.1016/j.ccrj.2023.05.005. eCollection 2023 Jun.

引用本文的文献

1
Accuracy Evaluation of GPT-Assisted Differential Diagnosis in Emergency Department.
Diagnostics (Basel). 2024 Aug 15;14(16):1779. doi: 10.3390/diagnostics14161779.

本文引用的文献

1
Implementing Machine Learning in the Electronic Health Record: Checklist of Essential Considerations.
Mayo Clin Proc. 2023 Mar;98(3):366-369. doi: 10.1016/j.mayocp.2023.01.013.
2
Assessing Disparities in COVID-19 Testing Using National COVID Cohort Collaborative.
Stud Health Technol Inform. 2022 Jun 29;295:316-319. doi: 10.3233/SHTI220726.
3
Using Big Data to Identify Impact of Asthma on Mortality in Patients with COVID-19.
Stud Health Technol Inform. 2022 May 25;294:352-356. doi: 10.3233/SHTI220473.
4
A Revised Comorbidity Model for Administrative Databases Using Clinical Classifications Software Refined Variables.
Cureus. 2021 Dec 14;13(12):e20407. doi: 10.7759/cureus.20407. eCollection 2021 Dec.
6
Latent COVID-19 Clusters in Patients with Chronic Respiratory Conditions.
Stud Health Technol Inform. 2020 Nov 23;275:32-36. doi: 10.3233/SHTI200689.
8
Using Big Data Analytics to Identify Dentists with Frequent Future Malpractice Claims.
Stud Health Technol Inform. 2020 Jun 16;270:489-493. doi: 10.3233/SHTI200208.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验