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JAHA:ST段抬高心肌梗死后30天再入院率时机、原因和费用分析

2018-09-14 xing.T MedSci原创

由此可见,三分之二的患者在STEMI后前14天内再次入院,并且大部分患者因非心脏原因再次入院。30天再入院与累积住院费用增加约50%相关。这些研究结果强调了在STEMI出院后的前几周内密切监测心脏和一般医疗状况的重要性。

ST段抬高心肌梗死(STEMI)后的再入院给医疗保健系统带来了巨大的经济负担。防止再入院的努力应基于了解这些再入院的时机和原因。近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,该研究旨在调查STEMI后30天再入院的原因、时机和成本。

所有STEMI住院治疗数据均来自与2010年至2014年期间的全国再入院数据库(NRD)。研究人员评估了30天再入院率以及再入院的主要原因和费用,并进行多变量回归分析以确定30天再入院的预测因子和增加的累积成本。

从2010年到2014年,STEMI后的30天再入院率为12.3%。出院后7天内,43.9%的受试者重新入院,67.3%的受试者在出院后14天内重新入院。从2010年到2014年,30天再入院率每年减少19%(P<0.001)。女性、艾滋病、贫血、慢性肾病、胶原血管疾病、糖尿病高血压、肺动脉高压、充血性心力衰竭、心房颤动和住院时间延长是30天再入院的独立预测因素。大部分患者(41.6%)因非心脏原因再次入院。多变量调整后,30天再入院与累积成本增加47.9%相关(P<0.001)。

由此可见,三分之二的患者在STEMI后前14天内再次入院,并且大部分患者因非心脏原因再次入院。30天再入院与累积住院费用增加约50%相关。这些研究结果强调了在STEMI出院后的前几周内密切监测心脏和一般医疗状况的重要性。

原始出处:

Luke K. Kim.et al.Thirty‐Day Readmission Rates, Timing, Causes, and Costs after ST‐Segment–Elevation Myocardial Infarction in the United States: A National Readmission Database Analysis 2010–2014.JAHA.2018. https://www.ahajournals.org/doi/full/10.1161/JAHA.118.009863

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    2018-10-15 smlt2008
  2. [GetPortalCommentsPageByObjectIdResponse(id=1977803, encodeId=2f7219e7803a5, content=<a href='/topic/show?id=93a211600a' target=_blank style='color:#2F92EE;'>#30天#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1160, encryptionId=93a211600a, topicName=30天)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39f145, createdName=smlt2008, createdTime=Mon Oct 15 16:29:00 CST 2018, time=2018-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345409, encodeId=022b34540976, content=再详细就更好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76d12257050, createdName=12177770m58暂无昵称, createdTime=Mon Sep 17 22:49:32 CST 2018, time=2018-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267921, encodeId=1599126e921de, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sat Sep 15 23:29:00 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423070, encodeId=1d2814230e002, content=<a href='/topic/show?id=936c16863b5' target=_blank style='color:#2F92EE;'>#ST段抬高#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16863, encryptionId=936c16863b5, topicName=ST段抬高)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=91d33758978, createdName=gdsun, createdTime=Sat Sep 15 23:29:00 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1529980, encodeId=2ece15299804b, content=<a href='/topic/show?id=bcc5306146d' target=_blank style='color:#2F92EE;'>#再入院率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30614, encryptionId=bcc5306146d, topicName=再入院率)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6a1e11986162, createdName=yzh403, createdTime=Sat Sep 15 23:29:00 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1542735, encodeId=39b71542e35c1, content=<a href='/topic/show?id=9117168e030' target=_blank style='color:#2F92EE;'>#ST段抬高心肌梗死#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16870, encryptionId=9117168e030, topicName=ST段抬高心肌梗死)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=095213453430, createdName=12498636m53(暂无昵称), createdTime=Sat Sep 15 23:29:00 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1624395, encodeId=25c216243955b, content=<a href='/topic/show?id=f27b16862d9' target=_blank style='color:#2F92EE;'>#ST段#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16862, encryptionId=f27b16862d9, topicName=ST段)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=676820671866, createdName=hyf035, createdTime=Sat Sep 15 23:29:00 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345104, encodeId=c81d345104f3, content=学习啦,就是不够详细, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/05/22/c26524b0b4ca80000d38f0294262c002.jpg, createdBy=3cf52015303, createdName=苏小雨, createdTime=Sat Sep 15 13:34:35 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=344959, encodeId=06a2344959ee, content=好文章,学习了,谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=173, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf1e1506062, createdName=nanhaizhihuo2009, createdTime=Fri Sep 14 09:33:27 CST 2018, time=2018-09-14, status=1, ipAttribution=)]
    2018-09-17 12177770m58暂无昵称

    再详细就更好了

    0

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    2018-09-15 zhaohui6731
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    2018-09-15 hyf035
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    2018-09-15 苏小雨

    学习啦,就是不够详细

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1977803, encodeId=2f7219e7803a5, content=<a href='/topic/show?id=93a211600a' target=_blank style='color:#2F92EE;'>#30天#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1160, encryptionId=93a211600a, topicName=30天)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39f145, createdName=smlt2008, createdTime=Mon Oct 15 16:29:00 CST 2018, time=2018-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345409, encodeId=022b34540976, content=再详细就更好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76d12257050, createdName=12177770m58暂无昵称, createdTime=Mon Sep 17 22:49:32 CST 2018, time=2018-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267921, encodeId=1599126e921de, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sat Sep 15 23:29:00 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423070, encodeId=1d2814230e002, content=<a href='/topic/show?id=936c16863b5' target=_blank style='color:#2F92EE;'>#ST段抬高#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16863, encryptionId=936c16863b5, topicName=ST段抬高)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=91d33758978, createdName=gdsun, createdTime=Sat Sep 15 23:29:00 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1529980, encodeId=2ece15299804b, content=<a href='/topic/show?id=bcc5306146d' target=_blank style='color:#2F92EE;'>#再入院率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30614, encryptionId=bcc5306146d, topicName=再入院率)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6a1e11986162, createdName=yzh403, createdTime=Sat Sep 15 23:29:00 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1542735, encodeId=39b71542e35c1, content=<a href='/topic/show?id=9117168e030' target=_blank style='color:#2F92EE;'>#ST段抬高心肌梗死#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16870, encryptionId=9117168e030, topicName=ST段抬高心肌梗死)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=095213453430, createdName=12498636m53(暂无昵称), createdTime=Sat Sep 15 23:29:00 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1624395, encodeId=25c216243955b, content=<a href='/topic/show?id=f27b16862d9' target=_blank style='color:#2F92EE;'>#ST段#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16862, encryptionId=f27b16862d9, topicName=ST段)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=676820671866, createdName=hyf035, createdTime=Sat Sep 15 23:29:00 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345104, encodeId=c81d345104f3, content=学习啦,就是不够详细, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/05/22/c26524b0b4ca80000d38f0294262c002.jpg, createdBy=3cf52015303, createdName=苏小雨, createdTime=Sat Sep 15 13:34:35 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=344959, encodeId=06a2344959ee, content=好文章,学习了,谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=173, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf1e1506062, createdName=nanhaizhihuo2009, createdTime=Fri Sep 14 09:33:27 CST 2018, time=2018-09-14, status=1, ipAttribution=)]
    2018-09-14 nanhaizhihuo2009

    好文章,学习了,谢谢!

    0

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