2149例非创伤性脑梗死/脑出血患者住院日影响因素分析

Influencing factors of hospitalization of 2 149 cases with non-traumatic cerebral infarction/cerebral hemorrhage

目的探讨非创伤性脑梗死／脑出血患者的住院日影响因素，为单病种住院日干预提供科学依据。方法利用医院病案系统，对2012年至2014年出院的非创伤性脑梗死／脑出血患者资料进行住院日影响因素分析。结果2149例非创伤性脑梗死／脑出血患者的中位数住院日13．00天，平均住院日16．79天。单因素与多元逐步回归显示，住院日长短与年龄、是否手术、是否转科、入院状态、入院途径、户口地址、离院方式、医保待遇等影响因素有关（P〈0．05）。结论入院时加强病史采集，明确高危人群；对高危人群及病情危重患者实行临床路径管理；有手术指征的患者，积极手术治疗；在医疗质量与安全的前提下，兼顾患者经济状况与治疗意愿，积极转科、转诊治疗等措施可有效缩短非创伤性脑梗死／脑出血患者的住院日。

Objective To Discuss influencing factors of hospitalization of patients with non-traumatic cerebral infarction/ cerebral hemorrhage, so as to provide scientific basis for intervention of single disease hospitalization. Methods With the use of hospital medical record system, influencing factors of hospitalization of patients with non-traumatic cerebral infarction/cerebral hemorrhage from 2012 to 2014 were analyzed. Results For 2 149 cases of non-traumatic cerebral infarction/cerebral hemor- rhage, the median hospitalization days were 13.00, and the average hospitalization days were 16.79. Univariate and multivariate stepwise regression showed that hospitalization days were relevant with age, surgery, switch departments, admission status, ad- mission route, account address, way away from the hospital, health care treatment and other factors related （P〈0.05）. Conclu- sion Such measures as strengthening admission history collection, clarification of high-risk groups, implementation of clinical path management for high-risk and critically ill patients, operations on patients with surgical indications, and under the premise of health care quality and safety, taking into account the wishes of the economic situation and treatment will of patients, positive transfer of Branches and hospitals can effectively shorten hospitalization days of non-traumatic cerebral infarction/cerebral hemor- rhage patients.