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首页> 外文期刊>Journal of Clinical Medicine Research >Determinants of Home Discharge Among Survivors of Necrotizing Fasciitis: A Population-Level Analysis
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Determinants of Home Discharge Among Survivors of Necrotizing Fasciitis: A Population-Level Analysis

机译：坏死性筋膜炎幸存者中家庭出院的决定因素：人口水平的分析

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Background: The majority of patients with necrotizing fasciitis (NF) in the United Sates survive their illness, and there is increasing interest in addressing the ability of survivors to return to their community following hospitalization. However, there are no data on the factors affecting home discharge among survivors of NF.Methods: We used the Texas Inpatient Public Use Data File to conduct a retrospective population-based examination of hospitalizations with NF aged 15 years or older between 2001 and 2010. Multivariate logistic regression modeling was used to explore predictors of home discharge among hospital survivors.Results: There were 10,724 NF hospitalizations surviving to discharge during study period, of which 62.5% were discharged home. The following key predictors have adversely affected odds of home discharge (odds ratio and 95% confidence intervals): age ≥ 75 years (0.349 (0.292 - 0.417)), Medicare insurance (0.582 (0.510 - 0.663)), congestive heart failure (0.836 (0.719 - 0.972)), chronic liver disease (0.684 (0.522 - 0.895)), respiratory failure (0.464 (0.386 - 0.558)), neurological failure (0.573 (0.418 - 0.787)), and need for mechanical ventilation (0.339 (0.199 - 0.578)). Increased odds of home discharge were found among males (1.116 (1.058 - 1.285)), Hispanics (1.193 (1.056 - 1.349)), those lacking health insurance (2.161 (1.183 - 2.521)) or managed at a teaching hospital (1.264 (1.127 - 1.418)).Conclusions: In this first population-level examination of the determinants of home discharge among survivors of NF, older age, Medicare insurance, selected comorbidities, and development of organ failure decreased patients’ odds of home discharge. Unexpectedly, male gender, Hispanic ethnicity, lack of health insurance, and being managed at a teaching hospital were associated with favorable impact on patients’ discharge disposition. Further studies are warranted in other populations and healthcare environments to corroborate the present findings and to refine our understanding of the factors affecting short-term outcomes among NF survivors.J Clin Med Res. 2016;8(7):537-543doi: http://dx.doi.org/10.14740/jocmr2573w
机译：背景：美国大部分的坏死性筋膜炎（NF）患者都可以幸存下来，并且越来越有兴趣解决幸存者住院后重返社区的能力。但是，目前尚无关于影响NF幸存者家庭出院的因素的数据。方法：我们使用了德克萨斯州住院病人公共用途数据文件对2001年至2010年间15岁或15岁以上NF的住院患者进行了回顾性人群调查。结果：在研究期间，共有10,724例NF住院患者幸存出院，其中62.5％出院。以下主要预测指标对家庭出院几率（赔率和95％置信区间）产生不利影响：年龄≥75岁（0.349（0.292-0.417）），医疗保险（0.582（0.510-0.663）），充血性心力衰竭（0.836） （0.719-0.972）），慢性肝病（0.684（0.522-0.895）），呼吸衰竭（0.464（0.386-0.558）），神经系统衰竭（0.573（0.418-0.787））和需要机械通气（0.339（0.199） -0.578））。男性（1.116（1.058-1.285）），西班牙裔（1.193（1.056-1.349）），缺乏健康保险（2.161（1.183-2.521））或在教学医院接受治疗的男性中发现出院的几率增加了（1.264（1.127） -1.418））结论：在首次人群水平的NF幸存者中，家庭出院决定因素，年龄，Medicare保险，部分合并症以及器官衰竭的发生率降低了患者出院的几率。出乎意料的是，男性，西班牙裔种族，缺乏健康保险以及在教学医院进行管理对患者出院的处置有积极影响。有必要在其他人群和医疗环境中进行进一步的研究，以证实目前的发现，并加深我们对影响NF幸存者短期结局的因素的理解。 2016; 8（7）：537-543doi：http://dx.doi.org/10.14740/jocmr2573w

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