| Item type |
文献 / Documents(1) |
| 公開日 |
2021-08-26 |
| アクセス権 |
|
|
アクセス権 |
open access |
| 資源タイプ |
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資源タイプ識別子 |
http://purl.org/coar/resource_type/c_6501 |
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資源タイプ |
journal article |
| 出版社版DOI |
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|
関連識別子 |
https://doi.org/10.1002/lrh2.10223 |
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関連名称 |
10.1002/lrh2.10223 |
| 出版タイプ |
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出版タイプ |
VoR |
|
出版タイプResource |
http://purl.org/coar/version/c_970fb48d4fbd8a85 |
| タイトル |
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|
タイトル |
Impact of a learning health system on acute care and medical complications after intracerebral hemorrhage |
| 著者 |
マツモト, コウタロウ
ノハラ, ヤスノブ
若田, 好史
ヤマシタ, タカノリ
コズマ, ユキオ
スゲタ, ルイ
ヤマカワ, ミキ
ヤマウチ, フミコ
ミヤシタ, エリ
タケザキ, タツヤ
ヤマシロ, シゲオ
ニシ, トオル
マチダ, ジロウ
ソエジマ, ヒデヒサ
カモウチ, マサヒロ
ナカシマ, ナオキ
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| 抄録 |
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内容記述 |
Introduction: Patients with stroke often experience pneumonia during the acute stage after stroke onset. Oral care may be effective in reducing the risk of stroke‐associated pneumonia (SAP). We aimed to determine the changes in oral care, as well as the incidence of SAP, in patients with intracerebral hemorrhage, following implementation of a learning health system in our hospital.
Methods: We retrospectively analyzed the data of 1716 patients with intracerebral hemorrhage who were hospitalized at a single stroke center in Japan between January 2012 and December 2018. Data were stratified on the basis of three periods of evolving oral care: period A, during which conventional, empirically driven oral care was provided (n = 725); period B, during which standardized oral care was introduced, with SAP prophylaxis based on known risk factors (n = 469); and period C, during which oral care was risk‐appropriate based on learning health system data (n = 522). Logistic regression analysis was performed to evaluate associations between each of the three treatment approaches and the risk of SAP.
Results: Among the included patients, the mean age was 71.3 ± 13.6 years; 52.6% of patients were men. During the course of each period, the frequency of oral care within 24 hours of admission increased (P < .001), as did the adherence rate to oral care ≥3 times per day (P < .001). After adjustment for confounding factors, a change in the risk of SAP was not observed in period B; however, the risk significantly decreased in period C (odds ratio 0.61; 95% confidence interval 0.43‐0.87) compared with period A. These associations were maintained for SAP diagnosed using strict clinical criteria or after exclusion of 174 patients who underwent neurosurgical treatment.
Conclusions: Risk‐appropriate care informed by the use of learning health system data could improve care and potentially reduce the risk of SAP in patients with intracerebral hemorrhage in the acute stage. |
| キーワード |
|
|
主題 |
learning health system |
| キーワード |
|
|
主題 |
oral care |
| キーワード |
|
|
主題 |
pneumonia |
| キーワード |
|
|
主題 |
stroke |
| 書誌情報 |
en : Learning Health Systems
巻 5,
号 2,
p. e10223,
発行日 2020-03-10
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| 収録物ID |
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収録物識別子タイプ |
ISSN |
|
収録物識別子 |
23796146 |
| 出版者 |
|
|
出版者 |
University of Michigan |
| 出版者 |
|
|
出版者 |
Wiley |
| 権利情報 |
|
|
権利情報 |
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| EID |
|
|
識別子 |
367552 |
| 言語 |
|
|
言語 |
eng |
lhs_5_2_e10223.pdf (791 KB)
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