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意大利慢性缺血性心血管疾病的临床、经济和组织影响:对2019年全国医院入院数据的评估

Clinical, Economical, and Organizational Impact of Chronic Ischemic Cardiovascular Disease in Italy: Evaluation of 2019 Nationwide Hospital Admissions Data.

作者信息

Pietrantonio Filomena, Carrieri Ciro, Rosiello Francesco, Spandonaro Federico, Vinci Antonio, d'Angela Daniela

机构信息

Internal Medicine Unit, Medical Area Department, Castelli Hospital, Asl Roma 6, 00040 Roma, Italy.

Faculty of Medicine and Surgery, St. Camillus University of Health Sciences, 00131 Rome, Italy.

出版信息

Int J Environ Res Public Health. 2025 Mar 31;22(4):530. doi: 10.3390/ijerph22040530.

Abstract

BACKGROUND

Chronic ischemic cardiovascular disease (CICD) is a common cardiovascular disease and a frequent cause of hospitalization, with significant differences between men and women. It is also an important comorbidity, affecting hospitalization length and mortality. The purpose of this paper is to investigate the clinical and economic impact of CICD on hospital admissions of non-surgical patients.

METHODS

To conduct the study, hospital discharge data (SDO) from each public and private hospital facility regularly sent by the regions to the Ministry of Health were analyzed, focusing on internal medicine, cardiology, and geriatrics departments' 2019 discharged data coming from all Italian hospitals. Data were stratified according to age, gender, hospital charge ward, and costs.

RESULTS

The typical CICD patient is elderly (average age 80 years) and stays longer (+10.5 days) compared to the average one. They are also typically chronic patients with many comorbidities (respiratory and renal failure, as well as atrial fibrillation) in geriatrics and internal medicine departments, while in the cardiology departments, atrial fibrillation and outcomes of acute cardiovascular events predominate.

CONCLUSIONS

CICD is a condition that leads to more hospitalizations in internal medicine departments than in cardiology and geriatrics departments and generates an average hospitalization value in line with the average one in internal medicine and geriatrics departments. In cardiology, the average value level is higher than the department average. Gender differences were found in cardiology departments; this data could suggest that the existing guidelines are affected by studies carried out mainly on males which lead to fewer recommendations for interventional procedures on females.

摘要

背景

慢性缺血性心血管疾病(CICD)是一种常见的心血管疾病,也是住院治疗的常见原因,男女之间存在显著差异。它也是一种重要的合并症,影响住院时间和死亡率。本文旨在研究CICD对非手术患者住院治疗的临床和经济影响。

方法

为开展该研究,分析了各地区定期发送给卫生部的每家公立和私立医院机构的出院数据(SDO),重点关注来自意大利所有医院的内科、心脏病科和老年病科2019年的出院数据。数据按年龄、性别、医院收费病房和费用进行分层。

结果

典型的CICD患者为老年人(平均年龄80岁),与平均水平相比住院时间更长(多10.5天)。他们通常也是患有多种合并症(呼吸和肾衰竭以及心房颤动)的慢性病患者,在内科和老年病科较为常见,而在心脏病科,心房颤动和急性心血管事件的结果更为突出。

结论

CICD导致内科住院的次数多于心脏病科和老年病科,其平均住院费用与内科和老年病科的平均水平一致。在心脏病科,平均费用水平高于科室平均水平。在心脏病科发现了性别差异;这些数据可能表明,现有指南受到主要针对男性进行的研究的影响,导致针对女性的介入手术建议较少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9e9/12026589/0f20e8039ece/ijerph-22-00530-g001.jpg

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