在神经外科部门对短期术后死亡率的比较:医院的行政数据是否足以进行风险调整?
Adam J Wahba1,2, Nick Phillips3, Ryan K Mathew4,3
1Clinical Effectiveness Unit, Royal College of Surgeons of England, 35-43 Lincoln's Inn Fields, London, WC2A 3PE, UK. ADAM.WAHBA@NHS.NET.
Acta neurochirurgica
|May 27, 2023
概括
使用医院数据的风险调整模型可以评估30天的神经外科手术死亡率. 包括脆弱性改善了模型性能,尽管创伤神经外科模型的效果不那么好.
科学领域:
- 神经外科 神经外科
- 医疗保健服务研究 医疗服务研究
- 医疗信息学 医疗信息学
背景情况:
- 手术死亡率指标需要进行风险调整,以准确评估组织绩效.
- 本研究侧重于使用英语医院行政数据的神经外科结果.
研究的目的:
- 评估神经外科手术后30天死亡率的风险调整模型.
- 用医院情节统计 (HES) 数据评估模型的性能.
主要方法:
- 使用HES数据 (2013-2018) 的回顾性队列研究.
- 开发了多变量后勤回归模型,其中包含了患者变量 (年龄,性别,剥夺,并发症,虚弱).
- 使用歧视和校准指标评估模型性能.
主要成果:
- 包括49,044名患者;整体30天死亡率为4.9%.
- 模型性能因子专业而异;脆弱和剥夺改善了创伤神经外科模型.
- 模型通常显示出良好的校准,组织死亡率略有变化.
结论:
- 使用HES数据,对神经外科手术死亡率的风险调整模型是可行的.
- 脆弱性测量通常会提高模型的性能.
- 与其他模型相比,创伤神经外科模型的效果不那么好.
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