Mortality of hospitalised internal medicine patients bedspaced to non-internal medicine inpatient units: retrospective cohort study
Mortality of hospitalised internal medicine patients bedspaced to non-internal medicine inpatient units: retrospective cohort study
复制标题
DOI：
10.1136/bmjqs-2017-006925
复制
发表时间：
2018-01-01
影响因子：
5.4
通讯作者：
Gill, Sudeep S.
中科院分区：
文献类型：
--
作者：
Bai, Anthony D.;Srivastava, Siddhartha;Gill, Sudeep S.
目的比较普通内科(GIM)门诊床位与指定GIM病房住院患者的住院死亡率。方法对加拿大一家大型三级护理医院2015年1月1日至2016年1月1日连续住院的GIM患者进行回顾性队列研究。使用Cox比例风险模型和竞争风险模型比较非服务病房(床位间隔)和分配给GIM病房的患者之间的住院死亡率。敏感性分析包括GIM服务团队、工作量、人口统计学、入院时间、入院原因和合并症的倾向评分和配对。结果在连续3243例GIM住院患者中，超过三分之一(1125例，35%)被安排到非服务病房，其余(2118例，65%)住进指定的GIM病房。在医院，176例(5%)患者死亡：88/1125(8%)卧床患者和88/2118(4%)分配到GIM病房的患者。与指定的GIM病房患者相比，床位间隔患者的HR为3.42(95%CI为2.23~5.26；P
Objective To compare inhospital mortality of general internal medicine (GIM) patients bedspaced to off-service wards with GIM inpatients admitted to assigned GIM wards.Method A retrospective cohort study of consecutive GIM admissions between 1 January 2015 and 1 January 2016 was conducted at a large tertiary care hospital in Canada. Inhospital mortality was compared between patients admitted to off-service wards (bedspaced) and assigned GIM wards using a Cox proportional hazards model and a competing risk model. Sensitivity analyses included propensity score and pair matching based on GIM service team, workload, demographics, time of admission, reasons for admission and comorbidities.Results Among 3243 consecutive GIM admissions, more than a third (1125, 35%) were bedspaced to off-service wards with the rest (2118, 65%) admitted to assigned GIM wards. In hospital, 176 (5%) patients died: 88/1125 (8%) bedspaced patients and 88/2118 (4%) assigned GIM ward patients. Compared with assigned GIM wards patients, bedspaced patients had an HR of 3.42 (95% CI 2.23 to 5.26; P