摘要
目的研究脑卒中患者院内死亡相关影响因素,为降低脑卒中院内死亡风险提供依据。方法收集2014年1月-2016年12月某中部地区31家医院脑卒中患者124 501例的住院病案首页数据,运用χ2分析方法对脑卒中患者院内死亡相关因素进行单因素检验,拟合两水平logistic回归模型分析脑卒中患者院内死亡影响因素。结果两水平logistic模型结果显示:高龄、危急重症、合并症CCI评分较高是脑卒中患者院内死亡的主要危险因素;每百张床位护士数的增加以及纳入临床路径和单病种管理是主要保护因素。结论两水平logistic模型可有效处理层次结构数据,使分析结果更加精确;对高龄、危急重症以及CCI评分较高患者应重点关注并及时采取针对性干预措施;关注医院水平因素影响,加强医务人员培训,规范脑卒中临床治疗。
Objectives To explore influencing factors which affected in-hospital mortality of stroke, in order to provide basis for reducing the risk. Methods To select stroke patients＇ medical records information in 31 hospitals in a province of central region from 2014 to 2016, chi-square test was used in univariate analysis, two-level logistic model was used to analyze the risk factors. Results Two-level logistic model indicated： older age, critical illness and high complication CCI score are main risk factors; and the number of nurses per 100 beds and the inclusion of clinical pathways and single disease management are main protective factors for stroke in-hospital mortality.Conclusions The two-level logistic model can effectively handle the hierarchical structure data and improve the analysis accuracy; focusing on patients of older age, critical severity and high CCI score, and taking targeted intervention measures; paying attention to the hospital factors effect and strengthen medical staff training to improve the standardization of clinical treatment.
作者
李珊
盛飞
张平安
Li Shan,Sheng Fei,Zhang Pingan(Department of Clinical Laboratory, Xiaogan Central Hospital of Hunan Province, Xiaogan 432100, Chin)
出处
《中国病案》
2018年第5期66-71,共6页
Chinese Medical Record
基金
湖北省自然科学基金立项课题(2015CKC904)
