胰腺切除术后再入院的分类以及针对性缓解策略的机会
Artem Boyev1, Ahad Azimuddin, Laura R Prakash
1Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Annals of surgery
|October 4, 2023
概括
大多数胰腺切除术再入院的原因是技术问题. 在出院前识别患有并发症,高白细胞计数或流体的患者可以帮助减少再入院.
科学领域:
- 胃肠病学 胃肠病学
- 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:
- 尽管初始医院护理的改善,但胰腺切除术的再入院率仍然很高.
- 了解再接收驱动因素对于提高患者的治疗结果和医疗保健效率至关重要.
研究的目的:
- 评估胰腺切除术后再入院的主要原因.
- 识别与再接收相关的风险因素,以告知质量改进倡议.
主要方法:
- 一个单一机构的病例控制研究分析了从2016年10月到2022年4月连续接受胰腺切除术的患者.
- 并发症被前性地分类,并分析了指数住院期间的风险因素.
- 90天再接收的迹象被分类.
主要成果:
- 在835名患者中,有24%的患者重新入院,主要原因是技术问题 (51%).
- 感染性 (17%) 和医疗/代谢性 (31%) 原因也很重要.
- 索引住院因素,如良性病理,胰腺或其他泄漏,器官空间感染,未排水的液体和升高的白细胞计数,独立预测重新入院.
结论:
- 技术并发症是胰腺切除术再入院的主要原因.
- 识别患有指数住院并发症,白细胞计数升高或流失液体的患者,可以帮助分层再接收风险.
- 释放前风险评估和加强门诊资源可能会降低再接收率.
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