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由于小肠阻塞而入院后延迟干预的影响:当代分析
Shannon Richardson1, Nikhil L Chervu1,2, Russyan Mark Mabeza1
1Cardiovascular Outcomes Research Laboratories, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America.
推迟小肠阻塞手术 (SBO) 会增加主要不良事件,停留时间和成本. 在患者人口统计学中标准化手术时间对于更好的结果至关重要.
科学领域:
- 手术成果研究的研究结果.
- 医疗服务研究 医疗服务研究
- 胃肠道手术 胃肠道手术
背景情况:
- 在小肠阻塞 (SBO) 病例中,手术干预的最佳时间是正在进行的辩论的主题.
- 及时的手术管理对于改善SBO患者的治疗结果至关重要.
研究的目的:
- 调查延迟手术干预对SBO患者临床结果和资源利用的影响.
- 为了确定SBO延迟外科治疗的预测因素.
主要方法:
- 从2018-2019年全国住院患者样本中分析成人SBO入院情况.
- 将患者分为"早期" (<3天) 和"延迟" (≥3天) 的手术干预队列.
- 多变量回归分析以评估延迟的预测因素及其与死亡率,重大不良事件 (MAE),并发症,停留时间 (LOS),成本和出院安排的关联.
主要成果:
- 超过一半 (52.0%) 的SBO患者经历了延迟的手术干预.
- 延迟干预与MAE,外科手术后并发症,更长的LOS (+1.29天),更高的成本 (+11,000美元) 和非家庭出院的几率增加有关.
- 黑人种族和医疗保险的覆盖范围独立地与延迟手术的更高可能性有关.
结论:
- 延迟SBO的手术治疗与较差的临床结果和医疗资源利用率的增加有关.
- 这些发现强调了对SBO进行标准化手术时间安排方案的必要性,以确保在不同患者群体中提供公平的护理.
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