哮喘患者急诊再就诊危险因素：基于人群的研究
2018/05/08
摘要
背景：相当一部分哮喘患者急诊出院后会再次返回医院。鉴于急诊护理的高额经济负担，以及对生产力和生活质量的影响，更好地了解哮喘患者急诊出院后返院的危险因素是非常有意义的。
目的：量化1年内随访哮喘患者急诊返回率，及哮喘患者返回急诊就诊的决定因素。
方法：调查5岁至99岁的加拿大安大略州居民2008~2014年因哮喘急诊就诊情况。描述性统计被用来比较那些急诊就诊未返回与急诊就诊返回的哮喘患者。采用调整后的修正Poisson回归模型估计哮喘患者急诊出院后1年内急诊再就诊的相对危险度。
结果：共有58366人符合纳入标准。在一年的随访中，12.1%至少一次急诊再就诊。更年轻的患者，物质贫乏和患有COPD等因素与一年内急诊再就诊显著相关。
结论：在哮喘患者初次急诊就诊出院一年内，有近1/8哮喘患者再次返回急诊就诊。针对那些有急诊就诊风险的人可能有助于改善医疗保健费用、生产力和生活质量。
Risk factors for return to the emergency department for asthma: a population-based study.
To T, Zhu J, Ryckman K, Gershon A.
Abstract
BACKGROUND: A substantial proportion of asthma patients return after being discharged from the emergency department (ED). Given the high economic burden of acute care claims, and the impact on productivity and quality of life, better understanding risk factors for ED return is of interest.
OBJECTIVE: To quantify the rate and determine factors associated with return to the ED for asthma within 1-year of an asthma ED visit.
METHODS: Individuals aged 5 to 99 years living in Ontario, Canada with an asthma ED visit in 2008-2014 were included. Descriptive statistics were used to compare those with an ED return to those without. An adjusted modified Poisson regression model was used to estimate the relative risk of ED return for asthma in the 1-year post- initial discharge.
RESULTS: In total, 58,366 individuals met the inclusion criteria. At 1-year follow-up, 12.1% returned to the ED at least once. Younger age, being materially deprived and having COPD were significantly associated with increased risk of ED return in the 1-year following the initial visit.
CONCLUSION: Nearly 1 in 8 individuals with a first asthma ED visit returned to the ED within a year of the initial ED discharge. Targeting those at risk for ED return may help improve health care costs, productivity and quality of life.
背景：相当一部分哮喘患者急诊出院后会再次返回医院。鉴于急诊护理的高额经济负担，以及对生产力和生活质量的影响，更好地了解哮喘患者急诊出院后返院的危险因素是非常有意义的。
目的：量化1年内随访哮喘患者急诊返回率，及哮喘患者返回急诊就诊的决定因素。
方法：调查5岁至99岁的加拿大安大略州居民2008~2014年因哮喘急诊就诊情况。描述性统计被用来比较那些急诊就诊未返回与急诊就诊返回的哮喘患者。采用调整后的修正Poisson回归模型估计哮喘患者急诊出院后1年内急诊再就诊的相对危险度。
结果：共有58366人符合纳入标准。在一年的随访中，12.1%至少一次急诊再就诊。更年轻的患者，物质贫乏和患有COPD等因素与一年内急诊再就诊显著相关。
结论：在哮喘患者初次急诊就诊出院一年内，有近1/8哮喘患者再次返回急诊就诊。针对那些有急诊就诊风险的人可能有助于改善医疗保健费用、生产力和生活质量。
(中日友好医院呼吸与危重症医学科 李红雯 摘译 林江涛 审校)
(J Allergy Clin Immunol Pract. 2018 Apr 28. pii: S2213-2198(18)30293-9.)
(J Allergy Clin Immunol Pract. 2018 Apr 28. pii: S2213-2198(18)30293-9.)
Risk factors for return to the emergency department for asthma: a population-based study.
To T, Zhu J, Ryckman K, Gershon A.
Abstract
BACKGROUND: A substantial proportion of asthma patients return after being discharged from the emergency department (ED). Given the high economic burden of acute care claims, and the impact on productivity and quality of life, better understanding risk factors for ED return is of interest.
OBJECTIVE: To quantify the rate and determine factors associated with return to the ED for asthma within 1-year of an asthma ED visit.
METHODS: Individuals aged 5 to 99 years living in Ontario, Canada with an asthma ED visit in 2008-2014 were included. Descriptive statistics were used to compare those with an ED return to those without. An adjusted modified Poisson regression model was used to estimate the relative risk of ED return for asthma in the 1-year post- initial discharge.
RESULTS: In total, 58,366 individuals met the inclusion criteria. At 1-year follow-up, 12.1% returned to the ED at least once. Younger age, being materially deprived and having COPD were significantly associated with increased risk of ED return in the 1-year following the initial visit.
CONCLUSION: Nearly 1 in 8 individuals with a first asthma ED visit returned to the ED within a year of the initial ED discharge. Targeting those at risk for ED return may help improve health care costs, productivity and quality of life.
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成人发病哮喘患者中肺功能恶化的预测因子
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鼻部疾病人群中哮喘控制的特点：一项横断面研究结果
