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高白蛋白血症与非计划就诊之间的关系:一项回顾性队列研究。

The Relationship Between Hyperalbuminemia and Unscheduled Medical Visits: A Retrospective Cohort Study.

作者信息

Ohta Ryuichi, Tsumura Kei, Sano Chiaki

机构信息

Community Care, Unnan City Hospital, Unnan, JPN.

Family Medicine, Fuchu Hospital, Osaka, JPN.

出版信息

Cureus. 2024 Jul 28;16(7):e65585. doi: 10.7759/cureus.65585. eCollection 2024 Jul.

Abstract

Introduction Hyperalbuminemia, defined as elevated serum albumin levels, may influence healthcare utilization, particularly unscheduled medical visits. The sympathetic nervous system (SNS) regulates serum albumin, which is crucial for maintaining oncotic pressure and substance transport. SNS instability, linked to chronic diseases, can impact albumin levels. This study investigates the association between hyperalbuminemia and unscheduled medical visits in community hospital outpatient departments, aiming to establish its potential as a predictor of healthcare utilization. Methods This retrospective cohort study utilized electronic medical records from Unnan City Hospital, Japan, from September 2021 to August 2023. Participants were over 15 years old and had albumin data available, excluding those with acute albumin conditions. The case group consisted of 321 hyperalbuminemia patients (serum albumin ≥ 5 g/dL), matched monthly with 16 controls. Data on demographics, chronic diseases, and unscheduled medical visits were collected. Multivariate logistic regression analyzed the association between hyperalbuminemia and unscheduled medical visits. Results Among 716 participants, the hyperalbuminemia group (mean age 59.13 years) was younger than the non-hyperalbuminemia group (mean age 74.36 years). Hyperalbuminemia patients had a higher BMI, pulse rate, and prevalence of diabetes, dyslipidemia, and brain stroke. Significant associations were found between hyperalbuminemia and unscheduled medical visits (OR 2.35, 95% CI 1.56-3.53, p < 0.001), age, BMI, pulse rate, and brain stroke. Conclusion Hyperalbuminemia is significantly associated with increased unscheduled medical visits in rural outpatient settings. Routine serum albumin assessments can aid in risk stratification and personalized care, potentially reducing acute healthcare needs. Future research should explore underlying mechanisms and broader populations to enhance clinical applications.

摘要

引言 高白蛋白血症定义为血清白蛋白水平升高,可能会影响医疗保健的利用情况,尤其是非计划内的就诊。交感神经系统(SNS)调节血清白蛋白,这对于维持胶体渗透压和物质运输至关重要。与慢性疾病相关的SNS不稳定会影响白蛋白水平。本研究调查社区医院门诊中高白蛋白血症与非计划内就诊之间的关联,旨在确定其作为医疗保健利用预测指标的潜力。方法 这项回顾性队列研究使用了日本云南市立医院2021年9月至2023年8月的电子病历。参与者年龄超过15岁且有可用的白蛋白数据,排除患有急性白蛋白疾病的患者。病例组由321例高白蛋白血症患者(血清白蛋白≥5 g/dL)组成,每月与16例对照进行匹配。收集了人口统计学、慢性疾病和非计划内就诊的数据。多因素逻辑回归分析了高白蛋白血症与非计划内就诊之间的关联。结果 在716名参与者中,高白蛋白血症组(平均年龄59.13岁)比非高白蛋白血症组(平均年龄74.36岁)年轻。高白蛋白血症患者的BMI、脉搏率以及糖尿病、血脂异常和脑卒中的患病率更高。高白蛋白血症与非计划内就诊(OR 2.35,95%CI 1.56 - 3.53,p < 0.001)、年龄、BMI、脉搏率和脑卒中有显著关联。结论 在农村门诊环境中,高白蛋白血症与非计划内就诊增加显著相关。常规血清白蛋白评估有助于进行风险分层和个性化护理,可能减少急性医疗需求。未来的研究应探索潜在机制并纳入更广泛的人群,以加强临床应用。

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