痛苦的社区指数作为呈现和术后结果的预测指标,在腹修复中
Sara M Maskal1, Jenny H Chang1, Ryan C Ellis1
1Cleveland Clinic, General Surgery, Cleveland, USA.
American journal of surgery
|June 18, 2023
概括
社会经济地位显著影响腹腔修复的结果,困难的社区经历了更紧急的呈现和更高的并发症率. 获得选择性手术和改善术后护理对于解决这些差异至关重要.
科学领域:
- 手术成果研究的研究结果.
- 关于健康公平性的研究.
- 公共卫生和流行病学.
背景情况:
- 社会经济地位 (SES) 是健康结果的关键决定因素.
- 腹腔修复是一种常见的外科手术程序,结果各不相同.
- 了解SES对修复的影响对于公平护理至关重要.
研究的目的:
- 评估社会经济地位对腹修复的呈现,管理和结果的影响.
- 根据社会经济因素,识别护理方面的差异.
主要方法:
- 利用了来自腹部核心健康质量协作团队的数据,用于成人腹腔修复患者.
- 使用困难社区指数 (DCI) 分配社会经济五分位数.
- 分析了症状,紧急情况,手术细节,30天的结果和一年的复发率,以及伤口并发症的多变量回归.
主要成果:
- 较高的DCI (陷入困境的社区) 与更紧急的呈现和受污染的病例相关.
- 增加的DCI与更高的再入院和重新手术率有关.
- 伤口并发症独立地与增加的DCI有关,尽管一年复发率在各组中相似.
结论:
- 在腹腔修复的呈现和外科手术前期结果中存在显著的不平等.
- 努力必须集中在提高获得可选外科手术程序的机会上.
- 改善术后伤口护理对于减轻差异至关重要.
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