术后并发症后的长期医疗保健使用:对连接的初级和二级护理例行数据的分析
Alexander J Fowler1,2, Adam B Brayne1,3, Rupert M Pearse1
1Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.
BJA open
|August 28, 2023
概括
患有术后并发症的患者,如感染或心脏病发作,医疗保健使用率和死亡率显著提高. 这凸显了手术并发症对患者长期结果和医疗保健资源利用的重大影响.
科学领域:
- 医疗保健研究的研究.
- 外科手术的结果
- 公共卫生 公共卫生
背景情况:
- 手术后并发症与长期存活率的降低有关.
- 了解并发症后的医疗保健利用模式至关重要.
研究的目的:
- 在哨兵术后并发症后,对医疗保健使用的变化进行表征.
- 分析并发症对医疗保健接触日和死亡率的影响.
主要方法:
- 选择性手术患者 (2012-2017年) 的初级和二级护理记录链接.
- 在手术后90天内确定了特定的并发症代码.
- 通过负二项回归分析了医疗保健接触日 (手术前和后2年) 和2年死亡率的变化.
主要成果:
- 患有并发症的患者 (7.8%) 在手术后与手术前相比,每年医疗保健接触率高出1.38倍.
- 没有并发症的患者在手术后每年医疗保健接触率高出1.14倍.
- 与并发症相关的医疗保健接触日的调整后发生率比为1.67.
- 在有并发症的患者 (10.1%) 中,2年内死亡率高于没有并发症的患者 (3.1%).
结论:
- 患有术后并发症的患者年龄较大,手术前医疗保健利用率较高.
- 手术后医疗保健使用率的绝对和相对增加,对于并发症患者来说要大得多.
- 手术后并发症显著提高了医疗保健需求,并与生存率降低有关.
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