慢性呼吸系统疾病加重患者住院时间及其预测

IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Journal of evaluation in clinical practice Pub Date : 2025-01-15 DOI:10.1111/jep.14308
Haya Tabaza, Rana Abu Farha, Lobna Gharaibeh, Mohammad Alwahsh, Oriana Awwad
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引用次数: 0

摘要

背景:慢性呼吸系统疾病如哮喘和慢性阻塞性肺疾病(COPD)可能恶化为急性加重,需要住院治疗。评估延长住院时间的预测因素可以帮助确定潜在的干预措施,以减轻患者和医疗保健系统的负担。目的:本研究旨在确定约旦慢性呼吸系统疾病急性加重患者住院时间延长的危险因素。方法:回顾性队列研究,回顾2017年1月至2021年7月住院哮喘和COPD加重患者的人口学和临床特征。对记录的变量进行独立性检查。然后进行简单和逐步多元线性回归,以确定与较长住院时间(LOS)显著相关的变量。结果:共评估896例。平均±SD停留时间为5.66±3.40天,中位(IQR)为5.00(4.00)天。多因素分析中与LOS延长相关的变量为女性(β = 0.089, p = 0.011)、肺动脉高压(β = 0.093, p = 0.004)、变应性鼻炎(β = 0.086, p = 0.007)、ICU住院(β = 0.096, p = 0.003)、机械通气需求(β = 0.102, p = 0.002)、总用药次数较高(β = 0.281, p)。性别、肺动脉高压、变应性鼻炎、入住ICU、机械通气、用药次数、吸烟与LOS有显著相关。这些发现强调了患者的人口统计学特征及其临床状况在确定LOS中的重要性,因此提供了保护性干预措施来缩短LOS。
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Length of Hospital Stay and Its Predictions Among Patients With Exacerbations of Chronic Respiratory Diseases

Background

Chronic respiratory disorders such as asthma and chronic obstructive pulmonary disease (COPD) may deteriorate into acute exacerbations requiring hospitalization. Assessing the predictors of prolonged hospital stays could help identify potential interventions to reduce the burden on patients and healthcare systems.

Aim

This study aimed to identify the risk factors attributed to prolonged hospital stays among patients admitted with acute exacerbations of chronic respiratory disorders in Jordan.

Methods

A retrospective cohort study was conducted by reviewing the demographic and clinical characteristics of hospitalized patients with asthma and COPD exacerbations between January 2017 and July 2021. The recorded variables were checked for their independence. Simple and stepwise multivariate linear regressions were then performed to identify variables associated significantly with a longer hospital length of stay (LOS).

Results

A total of 896 cases were evaluated. The mean ± SD stay was 5.66 ± 3.40 days, whereas the median (IQR) was 5.00 (4.00) days. Variables associated significantly with prolonged LOS in the multivariate analysis were female gender (β = 0.089, p = 0.011), pulmonary hypertension (β = 0.093, p = 0.004), allergic rhinitis (β = 0.086, p = 0.007), ICU admission (β = 0.096, p = 0.003), requirement for mechanical ventilation (β = 0.102, p = 0.002), higher total number of medications (β = 0.281, p < 0.001) and the number of exacerbation-related medications (β = 0.200, p < 0.001). However, smoking (β = −0.091, p = 0.008) was significantly associated with a shorter LOS.

Conclusions

Gender, pulmonary hypertension, allergic rhinitis, ICU admission, mechanical ventilation, the number of medications and smoking were significantly related to LOS. These findings emphasize the importance of patients' demographics and their clinical status in determining LOS, hence providing protective interventions to shorten it.

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来源期刊
CiteScore
4.80
自引率
4.20%
发文量
143
审稿时长
3-8 weeks
期刊介绍: The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.
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