非酒精性肝硬化手术:临床结果,医疗保健利用和成本分析
Christopher Tait1, Ankoor H Patel2, You Li1
1Division of Gastroenterology and Hepatology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA.
Cureus
|July 3, 2023
概括
非酒精性肝硬化患者的手术导致更糟糕的结果,包括更高的死亡率和不良肝病例. 此外,由于住院病例的增加,这一患者群体的医疗保健费用也显著增加.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 外科手术的结果
- 卫生经济学 卫生经济学
背景情况:
- 肝硬化增加了由于门高血压和血液静止变化的手术并发症风险.
- 虽然外科手术期间的管理得到了改善,但对肝硬化患者的手术成本和发病率的理解仍然不完整.
研究的目的:
- 评估与非酒精性肝硬化患者手术相关的结果和医疗费用.
- 为了比较手术与非手术性肝硬化患者的死亡率,不良事件和支出.
主要方法:
- 一项病例控制研究使用了IBM电子健康记录 (EHR) MarketScan商业索赔 (MSCC) 数据库 (2007-2017).
- 接受手术的非酒精性肝硬化患者被确定并与非手术性肝硬化对照进行匹配.
- 分析了手术后六个月的结果和成本.
主要成果:
- 手术患者的并发症指数,死亡率和不良肝脏结果 (例如,肝脏脑病,自发性细菌周周炎) 较高.
- 在手术组中观察到性休克,脑内出血和急性缺血性呼吸衰竭的增加率.
- 手术队列的医疗保健费用明显增加,原因是住院住院时间更长,住院时间更频繁.
结论:
- 接受手术的非酒精性肝硬化患者面临更糟糕的结果,包括不良的肝脏事件和诸如败血性休克和脑内出血等并发症.
- 在这一群体中,手术导致医疗保健支出大幅增加,主要是由于住院费用.
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