在大型三级医院手术室中,患者特异性预测手术延迟的因素
Natalie Meyers1, Sarah E Giron2, Ruth A Bush3
1Program of Nurse Anesthesia, University of Southern California, Los Angeles, CA.
概括
患者的种族,保险和健康状况预测了手术延迟. 监控麻醉护理增加了延迟几率,而心血管麻醉和肥胖症减少了它们,突出了影响选择性手术安排的因素.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 外科手术的结果
- 健康 公平 卫生 公平
背景情况:
- 选择性手术中的手术延迟可能会对患者的治疗结果和资源分配产生负面影响.
- 确定导致这些延迟的患者特定因素对于改善外科手术安排和患者护理至关重要.
研究的目的:
- 确定预测选择性手术病例手术延迟的患者特异性因素.
- 分析各种人口,临床和保险因素之间的联系以及经历手术延迟的可能性.
主要方法:
- 进行了一项回顾性队列研究,使用32818名接受选择性手术的患者的数据.
- 分析了电子健康记录,以提取患者特定的因素.
- 通过后勤回归后的双变量分析确定了手术延迟的显著预测因素.
主要成果:
- 增加手术延迟的因素包括监控麻醉护理,美国麻醉学会3级或以上,非裔美国人种族,功能衰竭,类固醇药物使用以及医疗补助或医疗保险.
- 六个外科专业也与延迟的可能性增加有关.
- 发现肥胖和心血管麻醉可以降低手术延迟的几率.
结论:
- 患者的保险类型,健康状况 (例如,功能衰竭,ASA类) 和种族是手术延迟的重要预测因素.
- 麻醉类型起着双重作用,监控麻醉护理增加了延迟风险,心血管麻醉减少了风险.
- 肥胖与延迟的可能性较低有关,这表明手术安排中的复杂相互作用.
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