转诊实践与症状胆病和胆囊炎治疗的延迟有关
Lt Brittany Cook1, Maj Rathnayaka M K D Gunasingha1, Lt Sydney Dishman2
1Uniformed Services University of the Health Sciences, 4301 Jones Bridge Ave, Bethesda, MD, 20814, USA; Department of Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD, 20814, USA.
American journal of surgery
|October 8, 2023
概括
对症状性胆结石的非手术提供者的转诊显著延迟了胆囊切除手术. 这种延迟延长了患者的症状,增加了医疗保健资源的利用率,影响了及时的手术管理.
科学领域:
- 外科胃肠道外科手术
- 医疗保健服务研究 医疗服务研究
背景情况:
- 有症状的胆结石 (胆结石) 通常需要手术干预.
- 及时的手术管理对于有效的治疗和症状缓解至关重要.
研究的目的:
- 调查非手术提供者的转诊与症状胆病的手术治疗延迟之间的关联.
- 量化非手术转诊对胆囊切除术时间的影响.
主要方法:
- 在2015-2019年间接受胆囊切除术的成年患者的回顾性图表审查.
- 使用独立的t测试对定量数据进行分析,以比较参考组.
主要成果:
- 在482名符合条件的患者中,38.8%的患者最初被转诊给非外科提供者.
- 被转诊给非手术提供者的患者在手术评估 (65.7 vs. 10.3天) 和胆囊切除术 (102.0 vs. 39.1天) 中的延迟显著更长.
- 统计学显著性得到证实,p<0.001对于两个结局措施.
结论:
- 向非手术提供者的转诊与胆囊切除术对症状胆结石的显著延迟有关.
- 延迟手术治疗延长了患者的症状,并增加了医疗保健资源的利用率.
- 优化转诊途径对于高效的胆病手术护理至关重要.
相关概念视频
Chronic Bowel Disorders: Introduction
464
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
464
Chronic Pancreatitis II: Collaborative Care
99
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
99
Endoscopic Procedures V: ERCP
311
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
311
Diseases of the Liver and Gallbladder
597
Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
597
Acute Pancreatitis II: Clinical Manifestations and Management
134
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
134
Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
13
Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
13

