...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Medicine. >'Weekend effect' on stroke mortality revisited: Application of a claims-based stroke severity index in a population-based cohort study
【24h】

'Weekend effect' on stroke mortality revisited: Application of a claims-based stroke severity index in a population-based cohort study

机译：重新研究对卒中死亡率的“周末效应”：基于人群的队列研究中基于索赔的卒中严重性指数的应用

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Previous studies have yielded inconsistent results on whether weekend admission is associated with increased mortality after stroke, partly because of differences in case mix. Claims-based studies generally lack sufficient information on disease severity and, thus, suffer from inadequate case-mix adjustment. In this study, we examined the effect of weekend admission on 30-day mortality in patients with ischemic stroke by using a claims-based stroke severity index.This was an observational study using a representative sample of the National Health Insurance claims data linked to the National Death Registry. We identified patients hospitalized for ischemic stroke, and examined the effect of weekend admission on 30-day mortality with vs without adjustment for stroke severity by using multilevel logistic regression analysis adjusting for patient-, physician-, and hospital-related factors. We analyzed 46,007 ischemic stroke admissions, in which weekend admissions accounted for 23.0%. Patients admitted on weekends had significantly higher 30-day mortality (4.9% vs 4.0%, P<0.001) and stroke severity index (7.8 vs 7.4, P<0.001) than those admitted on weekdays. In multivariate analysis without adjustment for stroke severity, weekend admission was associated with increased 30-day mortality (odds ratio (OR), 1.20; 95% confidence interval [CI], 1.08-1.34). This association became null after adjustment for stroke severity (OR, 1.07; 95% CI, 0.95-1.20).The weekend effect on stroke mortality might be attributed to higher stroke severity in weekend patients. While claims data are useful for examining stroke outcomes, adequate adjustment for stroke severity is warranted.
机译：先前的研究在周末入院是否与中风后死亡率增加有关方面产生不一致的结果，部分原因是病例组合不同。基于索赔的研究通常缺乏有关疾病严重性的足够信息，因此，病例组合调整不足。在这项研究中，我们使用基于索赔的卒中严重性指数检查了周末入院对缺血性卒中患者30天死亡率的影响，这是一项观察性研究，使用了与美国国家健康保险索赔数据相关的代表性样本国家死亡登记处。我们确定了因缺血性卒中住院的患者，并通过调整患者，医生和医院相关因素的多级逻辑回归分析，检查了周末入院对30天死亡率的影响，无论是否调整了卒中严重程度。我们分析了46,007例缺血性中风住院患者，其中周末入院患者占23.0％。周末收治的患者的30天死亡率（4.9％vs 4.0％，P <0.001）和中风严重度指数（7.8 vs 7.4，P <0.001）明显高于平日。在不对卒中严重性进行调整的多变量分析中，周末入院与30天死亡率增加相关（赔率（OR）为1.20; 95％置信区间[CI]为1.08-1.34）。调整卒中严重程度后，该关联为零（OR，1.07; 95％CI，0.95-1.20）。周末对卒中死亡率的影响可能归因于周末患者卒中严重程度的升高。尽管理赔数据对于检查卒中结果很有用，但仍需对卒中严重程度进行适当调整。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号