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术后持续时间作为术后医疗保健利用率增加的独立预测指标
Jacqueline Morin1, Seth Teplitsky2, Amber Bettis3
1Department of Urology, University of Kentucky, 780 Rose Street, Lexington, KY, 40536, USA.
International urology and nephrology
|September 15, 2023
概括
操作持续时间 (OD) 预测在微创性部分切除术 (MIPN),前列腺切除术 (MIP) 和囊切除术 (Cx) 中的医疗保健资源利用率 (HRU). 较长的OD显著增加了长期停留,再入院和退院到持续护理的风险.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术瘤学手术瘤学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 医疗保健资源利用率 (HRU) 是微创性泌尿外科手术中一个关键的结果指标.
- 在微创性部分切除术 (MIPN),前列腺切除术 (MIP) 和囊切除术 (Cx) 后,HRU的危险因素尚未得到充分定义.
- 手术持续时间 (OD) 是一个潜在的可修改因素,影响手术结果和资源使用.
研究的目的:
- 调查手术持续时间 (OD) 与术后医疗保健资源利用率 (HRU) 之间的关联.
- 为了确定OD是否是HRU的独立预测因素,在三个主要的微创性泌尿器科手术中进行:MIPN,MIP和Cx.
主要方法:
- 美国外科医生学院国家外科质量改进计划 (ACS-NSQIP) 数据库的分析.
- 包括接受MIPN,MIP和Cx的患者.
- 多变量回归分析以确定HRU的独立预测因子,定义为长时间停留,30天再入院或退院到持续护理设施.
主要成果:
- 总共分析了18904个MIPN,50807个MIP和12451个Cx病例.
- 增加的手术持续时间与所有三种手术中HRU的更高率显著相关 (p < 0.001).
- 较长的OD独立预测HRU增加:MIPN (>4.5h) 增加了3.5倍,MIP (>5h) 增加了3.7倍,Cx (>8.5h) 增加了2倍.
结论:
- 手术持续时间是手术后医疗保健资源利用率增加的重要独立预测因素,在微创性部分切除术,前列腺切除术和囊切除术中.
- 特定的手术持续时间值与这些手术中的HRU大幅增加有关,不管患者的并发症如何.
- 优化手术时间可能是缓解HRU的关键策略,在这些微创性泌尿外科手术中.
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