紧急胸部手术患者的风险调整结果比非紧急患者更差
Adam R Dyas1, Madeline B Thomas1, Michael R Bronsert1
1Surgical Outcomes and Applied Research Program, University of Colorado School of Medicine, Aurora, CO; Department of Surgery, University of Colorado Hospital, Aurora, CO.
Surgery
|July 28, 2023
概括
紧急胸部手术与非紧急手术相比,患者的治疗结果更差. 需要进一步分析,以确定在特定患者群体中导致这些不良事件的因素.
科学领域:
- 胸部外科手术 胸部外科手术
- 手术结果研究研究.
- 患者安全 患者安全
背景情况:
- 紧急胸部手术的结果没有得到充分的记录.
- 这项研究旨在比较紧急和非紧急胸部手术之间的术后结果.
研究的目的:
- 为了评估和比较30天的术后结果,患者接受紧急与非紧急胸部手术.
- 在不同手术队伍中识别与紧急胸部手术相关的特定并发症.
主要方法:
- 美国外科医生学院国家外科质量改善计划数据库 (2005-2018) 的回顾性分析.
- 使用程序代码识别紧急胸部手术.
- 分为四个队伍的分层:肺/胸壁,下垂,食道和心周.
- 使用单变数和多变数后勤回归对结果进行比较,控制手术前的因素.
主要成果:
- 在90,398次胸部手术中,4.5%是紧急情况.
- 在所有四个队伍中,紧急手术与更高的30天术后并发症率有关.
- 对风险进行调整后的分析显示,在紧急肺/胸壁,下垂和心周手术后,并发症增加.
- 在紧急食道手术中,没有发现风险调整后并发症的显著差异.
结论:
- 与非紧急手术相比,紧急胸部手术的风险调整结果较差.
- 接受紧急胸部手术的特定患者群体的不良结果负担更高.
- 建议进一步进行子集分析,以确定在特定的紧急胸部手术患者群体中导致不良结果的因素.
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