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优化不明原因嗜酸性粒细胞增多症患者的诊断和管理路径:紧急和非紧急评估的多学科方案

Optimizing diagnostic and management pathways for patients with eosinophilia of unknown origin: a multidisciplinary protocol for urgent and non-urgent evaluation.

作者信息

Sánchez-Ramón Silvia, Candelas Rodríguez Gloria, Gimeno Hernández Jesús, González Gutiérrez María Luisa, Medina Salazar Sissy Fiorella, Méndez Bailón Manuel, Navas Elorza Begoña, Nieto Sánchez Ángel, Robledo Echarren Teresa, Rueda Esteban Santiago, Fragiel Saavedra Marcos Oliver, Zamora Barrios María Dolores, Martínez Prada Cristina, Benavente Cuesta Celina, Pinedo Sierra Celia

机构信息

Department of Clinical Immunology, Hospital Clínico San Carlos, Madrid, Spain.

Department of Rheumatology, Hospital Clínico San Carlos, Madrid, Spain.

出版信息

Front Med (Lausanne). 2025 Jun 4;12:1544047. doi: 10.3389/fmed.2025.1544047. eCollection 2025.

Abstract

INTRODUCTION

Persistent eosinophilia of unknown cause is a key feature of numerous health disorders. These conditions present diagnostic and management challenges, often leading to delayed treatment, increased morbidity and mortality and unnecessary healthcare costs. A systematic approach to patient flow can streamline the process from presentation with eosinophilia to triage management, in hospital settings.

METHODS

A proposal of a novel patient flow pathway was developed through a collaborative effort involving 15 diverse multidisciplinary specialists in a public-funded tertiary teaching hospital located in Madrid, Spain, for managing eosinophilic diseases. This pathway focuses on early identification and expedited referral circuits in severe cases of hypereosinophilia and early screening of primary immunodeficient patients to optimize the journey from initial presentation through diagnosis and initial management.

RESULTS

The proposed patient flow model is designed to be replicable in other hospital settings. Its implementation aims to facilitate timely diagnosis and reduce the preventable morbidity, mortality, suffering and economic burden associated with complex eosinophilic conditions.

CONCLUSION

The development and implementation of a structured patient flow pathway for eosinophilia of unknown cause in a tertiary hospital setting demonstrates a significant step toward improving patient outcomes. This model serves as a template for other healthcare institutions seeking to enhance the management and care of patients with eosinophilic diseases.

摘要

引言

不明原因的持续性嗜酸性粒细胞增多是众多健康疾病的关键特征。这些病症带来了诊断和管理方面的挑战,常常导致治疗延误、发病率和死亡率增加以及不必要的医疗费用。在医院环境中,一种系统的患者流程方法可以简化从出现嗜酸性粒细胞增多到分诊管理的过程。

方法

在西班牙马德里一家公立三级教学医院,由15名不同的多学科专家共同努力,制定了一种新型患者流程路径的提案,用于管理嗜酸性粒细胞疾病。该路径侧重于在重度嗜酸性粒细胞增多症病例中进行早期识别和加快转诊流程,并对原发性免疫缺陷患者进行早期筛查,以优化从初次就诊到诊断及初始管理的整个过程。

结果

所提议的患者流程模型旨在可在其他医院环境中复制。其实施旨在促进及时诊断,并减少与复杂嗜酸性粒细胞病症相关的可预防的发病率、死亡率、痛苦和经济负担。

结论

在三级医院环境中为不明原因的嗜酸性粒细胞增多症开发并实施结构化的患者流程路径,朝着改善患者结局迈出了重要一步。该模型为其他寻求加强嗜酸性粒细胞疾病患者管理和护理的医疗机构提供了一个模板。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c16f/12174078/100418e13eb2/fmed-12-1544047-g001.jpg

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