Jones E, Jones J V
Department of Medicine, Dalhousie University, Halifax, NS, Canada.
J Rheumatol. 1994 Apr;21(4):728-32.
To assess factors influencing length of stay in a 12-bed rheumatic disease unit of a university associated teaching hospital with secondary and tertiary care responsibilities for a geographically broad referral base.
Patient discharges over a 12-month period were studied and divided into 3 categories.
In Category 1, 167 patients with a mean age of 47.12 had a hospital stay of 1-14 days. Within this group was a subgroup of 30 patients with systemic lupus erythematosus, mean age of 30.13 receiving iv pulse cyclophosphamide who had multiple admissions. Their omission elevated the mean age to 50.87. In Category 2, 81 patients with a mean age of 59, had a hospital stay of 15-28 days and in Category 3, 24 patients with a mean age of 50.9 were hospital stay of 15-28 days and in Category 3, 24 patients with a mean age of 50.9 were hospitalized more than 29 days. Principal diagnosis, major complications of disease, complications of procedure and treatment and concurrent nonrheumatologic pathologies were analyzed for each group. The presence of a large number of comorbid pathologies in Groups 1 and 2 relate to the tertiary referral nature of the practice. Category 2, the group with the higher mean age had more treatment related complications in the form of adverse reactions to 2nd line agents and nonsteroidal antiinflammatory drugs. The 24 patients in Category 3 showed an equal sex distribution and are noted for the presence of infectious agent arthritis, requiring longterm iv antibiotics, both as a principal diagnosis, and as a complication of other pathologies. Vasculitis as a complication of preexisting disease and as a principal diagnosis was also a feature of this group.
Length of stay above the 14 day mean relates to disease severity and serious complications such as vasculitis or joint sepsis requiring prolonged treatment.
评估影响一所承担二级和三级护理职责、服务于广泛地理转诊人群的大学附属医院12张床位的风湿病科室住院时间的因素。
对12个月期间的患者出院情况进行研究，并分为3类。
在第1类中，167名平均年龄为47.12岁的患者住院时间为1 - 14天。该组中有30名系统性红斑狼疮患者的亚组，平均年龄为30.13岁，接受静脉脉冲环磷酰胺治疗且多次入院。他们的排除使平均年龄升至50.87岁。在第2类中，81名平均年龄为59岁的患者住院时间为15 - 28天，在第3类中，24名平均年龄为50.9岁的患者住院时间超过29天。对每组患者的主要诊断、疾病的主要并发症、手术和治疗并发症以及并发的非风湿性病理情况进行了分析。第1组和第2组中大量共病情况与该科室的三级转诊性质有关。第2组平均年龄较高，有更多与治疗相关的并发症，表现为对二线药物和非甾体抗炎药的不良反应。第3类中的24名患者性别分布均衡，以感染性关节炎为特征，无论是作为主要诊断还是其他病理情况的并发症，都需要长期静脉使用抗生素。血管炎作为既往疾病的并发症和主要诊断也是该组的一个特征。
住院时间超过平均14天与疾病严重程度以及需要长期治疗的严重并发症如血管炎或关节脓毒症有关。
