欧洲手术后的死亡率:一项为期7天的队列研究
Rupert M Pearse1, Rui P Moreno, Peter Bauer
1Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK. r.pearse@qmul.ac.uk
Lancet (London, England)
|September 25, 2012
概括
欧洲外科结果研究发现,非心脏手术的住院患者死亡率高于预期. 欧洲国家之间的显著差异凸显了需要改进国家和国际患者护理策略的需要.
科学领域:
- 手术 手术 手术
- 公共卫生 公共卫生
- 医疗保健管理的管理
背景情况:
- 大型手术后的临床结果在全国范围内没有得到充分的记录.
- 医疗保健系统的变化表明了改善患者护理的潜力.
- 欧洲手术结果研究 (ESOS) 的目的是评估欧洲非心脏手术的结果.
研究的目的:
- 评估欧洲各地非心脏手术后的住院死亡率.
- 为了确定不同欧洲国家之间手术结果的差异.
- 评估二次结果,包括重症监护入院和住院时间.
主要方法:
- 一项为期7天的队列研究,涉及46539名16岁以上的患者,接受住院非心脏手术.
- 2011年4月4日至11日期间,来自28个欧洲国家的498家医院收集的数据.
- 多级逻辑回归模型用于调整国家间死亡率变化.
主要成果:
- 住院死亡率为4% (1855人死亡).
- 原始死亡率差异很大,从冰岛的1.2%到拉脱维亚的21.5%.
- 经过调整以考虑混因素后,死亡率在各国之间存在显著差异.
结论:
- 住院非心脏手术死亡率高于预期.
- 观察到的死亡率变化强调需要协调的国家和国际战略.
- 改善手术患者的护理需要解决影响结果的系统级因素.
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