目的 计算急性心肌梗死患者治疗质量的综合得分并进行经验logit变换,获得影响治疗质量的因素,为治疗质量的改善提供数据支持。 方法 收集急性心肌梗死患者数据,利用11个指标对急性心肌梗死患者的治疗质量进行评价,计算指标使用率和患者治疗质量综合得分;进行综合得分经验logit变换,获得综合得分的变换值进行统计描述;以目标变量为经验logit变换的综合得分,利用线性回归模型分析治疗质量的影响因素。 结果 本研究收集急性心肌梗死患者4 137例;使用率最高的指标为住院期间氯吡格雷的使用,使用率最低的为住院前12-lead ECG。经验logit变换的综合得分服从正态分布,门诊入院的患者综合得分经验logit变换值最高为0.705 4±0.645 5,住院天数≤7天最低为0.194 3±0.605 1。治疗质量影响因素分析结果为:大年龄,急诊入院,梗死部位发生在下壁、多壁的治疗质量较差;双休日入院、住院时间和住院费增加、合并症数量少的治疗质量较好。 结论 利用线性回归分析治疗质量综合得分的影响因素,从数据的角度应考虑治疗质量综合得分的正态性问题,建议进行数据的logit变换;改善急性心肌梗死患者的治疗质量,应关注年龄大,急诊和工作日入院,心肌梗死部位多,合并症数量多及住院时间短的患者。

Objective The comprehensive score of treatment quality of AMI patients was calculated and empirical Logit transformation was performed. To obtain the factors affecting the quality of treatment, To provide data support for the improvement of treatment quality.Methods The data of AMI patients were collected, the treatment quality of AMI patients was evaluated with 11 indexes, and the comprehensive scores of index utilization rate and treatment quality of patients were calculated. The empirical Logit transformation was carried out for the comprehensive score to obtain the transformation value of the comprehensive score for statistical description. The target variable was taken as the comprehensive score of the empirical Logit transformation, and the linear regression model was used to analyze the influencing factors of treatment quality.Results In this study, 4 137 AMI patients were collected. The highest utilization rate was the use of clopidogrel during hospitalization, and the lowest was the 12-lead ECG before hospitalization. The comprehensive score of the empirical Logit transformation followed the normal distribution. The maximum value of the comprehensive score of the outpatient admission was 0.705 4±0.645 5, and the minimum value of the hospitalization days 7 days and below was 0.194 3±0.605 1. The analysis results of influencing factors of treatment quality showed that the treatment quality was poor in older age, emergency admission, infarction location in the lower wall and multi-wall. The quality of treatment was better in admission during the weekend, increased hospital stay and hospitalization expenses, and fewer complications.Conclusion Linear regression was used to analyze the influencing factors of comprehensive score of treatment quality, the normality of comprehensive score of treatment quality should be considered from the data point of view, and Logit transformation of data is suggested. In order to improve the treatment quality of AMI patients, attention should be paid to patients who are older, hospitalized in emergency, admitted during working days, and have more myocardial infarction sites, more complications and shorter hospitalization time.