武汉市青年结核患者超长住院日影响因素分析

Analysis of the Influence of Excessive Hospital Stay on Young Tuberculosis Patients in Wuhan

目的 研究青年结核患者超长住院日的影响因素,并依此提出针对性的改进策略。方法 选取武汉市某三级呼吸专科医院近3年因结核病首次入院治疗的年龄在15~44岁的青年患者7 947例,通过病案首页获取患者基本信息、入院信息、住院日以及诊断和手术/操作信息,按住院日是否>30天分为超长住院日组和常规住院日组,通过单因素分析确定两组患者相关指标的分布特征,将单因素分析中的变量引入二元logistic回归分析模型。结果 青年结核患者超长住院发生率为1.84%,回归分析结果显示,患者急诊入院、入院后有转科、输血、手术/操作、药物不良反应以及结核系统分类为非呼吸系统结核是形成超长住院的影响因素,差异有统计学意义(P<0.05)。结论 青年结核患者超长住院比例相对较低,肺外结核以及有药物不良反应的患者超长住院的概率更高,建议提高结核病防治宣传力度,探索新的结核治疗方案,降低药物不良反应发生,同时医院要加强医疗质量管理,优化服务流程,进一步减轻青年结核患者疾病负担。

Objective To study the influencing factors of excessive hospital stay in young tuberculosis patients and make targeted policy recommendations.Methods In a tertiary respiratory specialized Hospital in Wuhan,inpatients aged 15-44 who were diagnosed with tuberculosis on their first hospitalization were included,making a sample of7 947 young patients.Patients with inpatient length of stay over 30 days were clustered as excessive hospital stay group while the others clustered as regularhospital stay group.Both Univariate analysis and logistic regression models were employed to explore the possible influencing factors of super-long excessive hospital stay.Results The incidence of excessive hospital stay among young tuberculosis patients in Wuhan was 1.84%.Regression analysis showed that emergency patients,with inpatient transfer,blood transfusions,surgery/operation,occurrence of drug adverse reactions and non-respiratory tuberculosis were the influencing factors of super long hospitalization(P<0.05).Conclusion The percentage of patients with excessive hospital stay among young patients was relatively low.Patients with extrapulmonary tuberculosis or adverse drug reactions would promote the probability of excessive hospital stay.The disease burden of young adults with TB can be further reduced based on improved TB prevention and treatment advocacy,new treatment options of tuberculosis,strengthened medical quality management and optimized healthcare delivery processes.