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Stroke:机械通气的卒中患者再入院率增高?

2015-08-31 MedSci MedSci原创

气管切开术是严重缺血性卒中,脑出血,蛛网膜下腔出血患者常用的处理方式。但是对行机械通气的卒中患者的再入院率的了解较少。我们按照国际疾病分类法,第九版临床修订准则,收集3个州的非联邦急诊护理医院所有的出院患者的数据。我们比较行机械通气的卒中患者的再入院率,这些卒中患者分为行气管切开术和未行气管切开术两类。在39881名在卒中住院期间行机械通气,并且存活到出院的患者,10690名(26.8%, 95%

气管切开术是严重缺血性卒中、脑出血、蛛网膜下腔出血患者常用的处理方式。但是对行机械通气的卒中患者的再入院率的了解较少。

研究人员按照国际疾病分类法,第九版临床修订准则,收集3个州的非联邦急诊护理医院所有的出院患者的数据。研究人员比较行机械通气的卒中患者的再入院率,这些卒中患者分为行气管切开术和未行气管切开术两类。

在39881名在卒中住院期间行机械通气,并且存活到出院的患者,10690名(26.8%, 95%CI为26.4%-27.2%)患者行气管切开术。平均随访时间为3.4(±2)年,每三十天再入院率为4.24% (95%CI, 4.22-4.28)。行气管切开术的患者的30天再入院率为26.9%,而未行气管切开术的患者的再入院率为22.5%(绝对风险差值4.4%,95%CI, 3.5%-5.4%)。校正潜在混杂变量后,气管切开与再入院率升高相关(RR1.07;95%CI, 1.03-1.11)。

约有四分之一的进行机械通气的卒中患者,存活到出院,并且30天内再入院。行气管切开术的卒中患者,再入院率明显升高,但是差异没有临床意义。机械通气的卒中患者30天再入院率与重大医疗疾病(比如肺炎)的医疗保险受益人住院治疗率相似。

原文出处:

Lahiri S, Navi BB, Mayer SA,et al. Hospital Readmission Rates Among Mechanically Ventilated Patients With Stroke. Stroke. 2015 Aug 13. pii: STROKEAHA.115.010441. [Epub ahead of print]


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    2015-09-02 liuxiaona
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    2015-09-02 liuxiaona

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