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美国癌症住院患者因心血管疾病导致的非计划再入院率、时间及持续时间

Rate, Timing, and Duration of Unplanned Readmissions Due to Cardiovascular Diseases among Hospitalized Patients with Cancer in the United States.

作者信息

Han Sola, Sohn Ted J, Avanceña Anton L V, Park Chanhyun

机构信息

Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, Austin, TX 78712, USA.

出版信息

Rev Cardiovasc Med. 2023 Nov 23;24(11):326. doi: 10.31083/j.rcm2411326. eCollection 2023 Nov.

Abstract

BACKGROUND

Cardiovascular disease (CVD) can lead to unplanned care in patients with cancer, which may affect their prognosis and survival. We aimed to compare the rates, timing, and length of stay of unplanned CVD readmission in hospitalized patients with and without cancer.

METHODS

This study used the 2017-2018 Nationwide Readmissions Database to identify adult hospitalized patients with and without cancer. The primary outcome was 180-day unplanned CVD readmission rates. CVD was defined based on a composite variable that included atrial fibrillation, coronary artery disease, cardiomegaly, cardiomyopathy, heart failure, peripheral artery disease, and stroke. For patients readmitted due to CVD, the timing between admissions (based on the mean number of days between index hospitalization and readmission) and length of stay were further identified.

RESULTS

After matching, 300,398 patients were included in the two groups. The composite CVD readmission rates were significantly higher in patients with cancer (5.92% vs 4.10%; odds ratio (OR) 1.47, 95% CI 1.44-1.51, 0.001). Patients with cancer were also associated with shorter mean number of days to composite CVD readmission (60.48 days vs 68.32 days, 0.001) and longer length of stay of composite CVD readmission (8.21 days vs 7.13 days, 0.001). These trends were maintained in analyses of the individual CVD.

CONCLUSIONS

Hospitalized patients with cancer experienced higher rates of unplanned readmission due to CVD, and their CVD readmissions occurred sooner and required longer lengths of stay compared to patients without cancer. Efforts to reduce unplanned CVD readmissions, such as providing optimized chronic post-discharge care, may improve the health outcomes of patients with cancer.

摘要

背景

心血管疾病(CVD)可导致癌症患者接受非计划治疗,这可能会影响他们的预后和生存。我们旨在比较有癌症和无癌症的住院患者中非计划CVD再入院的发生率、时间和住院时长。

方法

本研究使用2017 - 2018年全国再入院数据库来识别有癌症和无癌症的成年住院患者。主要结局是180天非计划CVD再入院率。CVD是基于一个综合变量定义的,该变量包括心房颤动、冠状动脉疾病、心脏肥大、心肌病、心力衰竭、外周动脉疾病和中风。对于因CVD再次入院的患者,进一步确定两次入院之间的时间间隔(基于首次住院和再入院之间的平均天数)和住院时长。

结果

匹配后,两组共纳入300,398例患者。癌症患者的综合CVD再入院率显著更高(5.92%对4.10%;比值比(OR)1.47,95%置信区间1.44 - 1.51,P < 0.001)。癌症患者发生综合CVD再入院的平均天数也更短(60.48天对68.32天,P < 0.001),且综合CVD再入院的住院时长更长(8.21天对7.13天,P < 0.001)。这些趋势在对个体CVD的分析中得以维持。

结论

与无癌症患者相比,癌症住院患者因CVD导致的非计划再入院率更高,且他们的CVD再入院发生得更早,住院时间更长。采取措施减少非计划CVD再入院,如提供优化的出院后慢性护理,可能会改善癌症患者的健康结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cfe/11272843/db4dbcd8e231/2153-8174-24-11-326-g1.jpg

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