昼间选择性腹腔镜胆囊切除术的并发症,由前一天晚上进行手术的外科医生进行
Christopher Vinden1, Danielle M Nash, Jagadish Rangrej
1Division of General Surgery, Department of Surgery, Western University, London, Ontario, Canada2Institute for Clinical Evaluative Sciences, London, Ontario, Canada.
JAMA
|November 7, 2013
概括
选择性手术前一天晚上进行手术的外科医生没有增加患者并发症的风险,包括转换为开放手术,阳性损伤或死亡. 这些发现表明,夜间工作的外科医生在白天手术过程中不会损害患者的安全.
科学领域:
- 手术结果研究研究.
- 患者安全 患者安全
- 医疗保健专业人员的睡眠剥夺
背景情况:
- 外科医生睡眠障碍对患者结果的影响尚不清楚.
- 评估一夜间手术的外科医生进行的选择性手术的安全性对于患者护理至关重要.
研究的目的:
- 为了确定在选择性手术前一晚进行手术的外科医生是否面临患者并发症率的增加.
- 调查外科医生的夜间工作与随后白天选择性手术中不良事件之间的关联.
主要方法:
- 一项以人口为基础的回顾性队列研究利用了加拿大安大略省的行政医疗保健数据库.
- 匹配分析对2078名患者进行了选择性腹腔镜胆囊切除术,这些患者的外科医生在一夜之间进行了手术,与8312名对照人进行了比较.
主要成果:
- 从腹腔镜切除术到开放胆囊切除术的转化率没有显著差异 (2.2%对1.9%).
- 阳性损伤 (0.7%对0.9%) 和死亡 (≤0.2%对0.1%) 的风险也与前一天晚上进行手术的外科医生没有显著关联.
结论:
- 在选择性白天胆囊切除术前一晚进行手术并没有增加转化风险,阳性并发症或死亡风险.
- 这些发现不支持在一夜间手术后进行选择性手术的外科医生安全问题.
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