在内脏外科手术手术后,重症监护病床的术后使用
Franziska Peters1, Sven Hohenstein, Andreas Bollmann
1Department of General and Visceral Surgery, Helios Kliniken Schwerin, Schwerin, Germany; Real World Evidence and Health Technology Assessment at Helios Health Institute, Berlin, Germany; Helios Health, Berlin, Germany; Helios Health Institute, Berlin, Germany.
Deutsches Arzteblatt international
|July 10, 2023
概括
内脏手术患者的重症监护利用率正在下降,需要术后重症监护的患者数量越来越少. 住院死亡率保持稳定,表明治疗策略正在发展.
科学领域:
- 手术 手术 手术 术 术
- 密集护理医学 密集护理医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 关于需要的重症监护病床数量存在争议.
- 内脏外科手术患者的术后重症监护需求是重点关注的重点.
- 了解重症监护利用趋势对于资源配置至关重要.
研究的目的:
- 描述性地分析内脏手术患者的术后重症监护.
- 检查重症监护室 (ICU) 占用率的频率,持续时间和趋势.
- 评估COVID-19大流行对这些患者的ICU利用的影响.
主要方法:
- 来自Helios组 (2016-2021) 的常规住院患者数据的回顾性分析.
- 包括71家急性护理医院的24,888例病例.
- 专注于三个指标手术:结肠直肠切除,胃癌手术和左胰腺切除.
主要成果:
- 观察到重症监护利用率下降,例如,结肠直肠切除病例从84.2% (2016) 降至63.1% (2021).
- 机械通风率略有下降 (2016年为10.3%,2021年为8.9%).
- 住院死亡率保持稳定 (4.1%-5.2%),而手术量则有所变化.
结论:
- 内脏外科手术患者继续接受常见的术后重症监护,尽管利用率正在缓慢下降.
- 没有针对患者人口统计或并发症进行调整.
- 研究结果突出显示,内脏外科手术的术后重症监护需要不断变化的模式.
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