冠心病患者经皮冠状动脉介入治疗手术超长住院影响因素的探究  

An Investigation of the Influencing Factors Associate with Prolong Hospital Stay in Coronary Heart Disease Patients Underwent Percutaneous Coronary Intervention

作　　者：杜思唯 戴峰飞越 沈童童 黄琳莹 蔡建辉 黄煜 邱亨嘉 Du Siwei;Dai Fengfeiyue;Shen Tongtong;Huang Linying;Cai Jianhui;Huang Yu;Chiu Herng-chia(Institute for Hospital Management,Tsinghua University,Shenzhen 518055,Guangdong Province,China;不详)

机构地区：[1]清华大学医院管理研究院,广东省深圳市518055 [2]约翰·霍普金斯大学公共卫生学院,美国MD4321

出　　处：《中国病案》2024年第7期73-76,共4页Chinese Medical Record

摘　　要：目的探究北京市某三甲医院主要诊断为心绞痛和急性心肌梗死的患者在接受PCI后超长住院的情况及其影响因素。方法选取在北京市某三甲医院5年期间所有接受PCI治疗并出院的3178名患者的住院病案首页信息,以是否超长住院为因变量,年龄、性别、疾病诊断、合并症、手术情况与PCI既往史、医保类型、就医方式与入院途径为自变量,采用Logistic(逻辑)回归的方法分析超长住院的影响因素。结果年龄、就医方式、支架数量、入院途径、主要诊断、操作血管数量以及PCI既往史等变量是显著影响冠心病患者PCI治疗是否超长住院的因素。结论年龄越大、异地就医、经由门诊入院、主要诊断为急性心肌梗死、操作血管数量越少、支架数量越多以及有PCI既往史是冠心病患者PCI治疗超长住院的影响因素。在DRG支付环境和节约医疗资源使用的考虑下,医院和医疗团队在患者入住时需要关注具有以上特征患者的照护模式以提高医疗质量和效率。Objectives This study aims to explore the incidence and influencing factors of prolonged hospital stays following PCI surgery in patients primarily diagnosed with angina pectoris and acute myocardial infarction at a tertiary hospital in Beijing.Methods The front page information of all 3178 patients who received PCI treatment and were discharged from a tertiary hospital in Beijing during the 5-year period was selected.The dependent variable was whether the patient experienced an extended hospital stay,while independent variables included age,gender,diagnosed diseases,comorbidities,surgical conditions,previous history of PCI,type of medical insurance,medical treatment methods,and admission route.Multiplelogistic regression was used to analyze the influencing factors of prolonged hospitalization.Results Factors such as age,medical treatment method,number of stents,route of admission,main diagnosis,number of operated blood vessels,and previous history of PCI were found to significantly influence whether patients with coronary heart disease would experience prolonged hospitalization after PCI treatment.Conclusions Factors such as older age,medical treatment received elsewhere,admission via outpatient clinic,main diagnosis of acute myocardial infarction,fewer operated blood vessels,more stents,and a history of previous PCI are influential in determining prolonged hospitalization for PCI treatment in patients with coronary heart disease.Under the condition of the DRG payment environment and the imperative to conserve medical resources,hospitals and medical teams should prioritize the care model for patients with the aforementioned characteristics upon admission,aiming to enhance medical quality and efficiency.

关 键 词：冠心病 经皮冠状动脉介入治疗 超长住院 LOGISTIC回归 

分 类 号：R541.4[医药卫生—心血管疾病]