The burden of acute heart failure on U.S. emergency departments.
The burden of acute heart failure on U.S. emergency departments.
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美国急诊室急性心力衰竭的负担。
DOI：
10.1016/j.jchf.2014.01.006
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发表时间：
2014-06
期刊：
影响因子：
--
通讯作者：
Collins SP
中科院分区：
文献类型：
--
作者：
Storrow AB;Jenkins CA;Self WH;Alexander PT;Barrett TW;Han JH;McNaughton CD;Heavrin BS;Gheorghiade M;Collins SP
本研究的目的是检查2006年至2010年急诊科（ED）的入院率、医院程序、住院时间和急性心力衰竭（AHF）的费用。AHF患者经常住院，并伴有高再入院率和费用。我们利用2006年至2010年的全国急诊科样本AHF数据来描述住院比例、住院时间（LOS）和急诊科收费作为资源利用的替代指标。结果比较了美国各地区、患者保险状况和医院特征。在美国，AHF患者平均每年有958,167次急诊科就诊。51%的患者为女性，中位年龄为75.1岁（四分位数间距[IQR]: 62.5 ~ 83.7岁）。总体上，83.7%（95%可信区间：83.1% ~ 84.2%）被录取；中位生存期为3.4天（IQR: 1.9 ~ 5.8天）。2006年与2010年相比，LOS中位数略有下降（0.09天），但承认的比例没有变化。根据年龄、性别、医院特征（学术和安全网状况）和保险（医疗保险、医疗补助、私立、自费/免费）进行调整后，东北地区的入学率最高。2006年的ED收费中位数为1,075元（IQR: 679元至1,665元），2010年为1,558元（IQR: 1,018元至2,335元）。没有保险的患者更有可能从急诊科出院，但当他们入院时，更有可能接受重大的诊断或治疗程序。患有AHF的ED患者在全国范围内住院的比例非常高，即使在调整了潜在的混杂因素后，根据国家的地区和保险类型，处置和程序决定也存在显著差异。
The goal of this study was to examine 2006 to 2010 emergency department (ED) admission rates, hospital procedures, lengths of stay, and costs for acute heart failure (AHF). Patients with AHF are often admitted and are associated with high readmissions and cost. We utilized Nationwide Emergency Department Sample AHF data from 2006 to 2010 to describe admission proportion, hospital length of stay (LOS), and ED charges as a surrogate for resource utilization. Results were compared across U.S. regions, patient insurance status, and hospital characteristics. There were 958,167 mean yearly ED visits for AHF in the United States. Fifty-one percent of the patients were female, and the median age was 75.1 years (interquartile range [IQR]: 62.5 to 83.7 years). Overall, 83.7% (95% confidence interval: 83.1% to 84.2%) were admitted; the median LOS was 3.4 days (IQR: 1.9 to 5.8 days). Comparing 2006 with 2010, there was a small decrease in median LOS (0.09 days), but the proportion admitted did not change. Odds of admission, adjusting for age, sex, hospital characteristic (academic and safety net status), and insurance (Medicare, Medicaid, private, self-pay/no charge) were highest in the Northeast. Median ED charges were $1,075 (IQR: $679 to $1,665) in 2006 and $1,558 (IQR: $1,018 to $2,335) in 2010. Patients without insurance were more likely to be discharged from the ED, but when admitted, were more likely to receive a major diagnostic or therapeutic procedure. A very high proportion of ED patients with AHF are admitted nationally, with significant variation in disposition and procedural decisions based on region of the country and type of insurance, even after adjusting for potential confounding.
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急性心力衰竭的风险分层：分层和决策研究的基本原理和设计。
影响因子：
4.8
作者：
Collins, Sean P.;Lindsell, Christopher J.;Jenkins, Cathy A.;Harrell, Frank E.;Fermann, Gregory J.;Miller, Karen F.;Roll, Sue N.;Sperling, Matthew I.;Maron, David J.;Naftilan, Allen J.;McPherson, John A.;Weintraub, Neal L.;Sawyer, Douglas B.;Storrow, Alan B.
通讯作者：
Storrow, Alan B.
影响因子：
6.3
作者：
Isaacs CG;Kistler C;Hunold KM;Pereira GF;Buchbinder M;Weaver MA;McLean SA;Platts-Mills TF
通讯作者：
Platts-Mills TF
影响因子：
37.8
作者：
Chen, Jersey;Normand, Sharon-Lise T.;Krumholz, Harlan M.
通讯作者：
Krumholz, Harlan M.
影响因子：
3.5
作者：
Makoul, G;Clayman, ML
通讯作者：
Clayman, ML
影响因子：
120.7
作者：
Chen, Jersey;Normand, Sharon-Lise T.;Krumholz, Harlan M.
通讯作者：
Krumholz, Harlan M.