在急性尾炎的知识与行动差距的负担
Stefano Piero Bernardo Cioffi1,2, Michele Altomare3,4, Mauro Podda5
1Advanced Technologies in Surgery, Department of Surgical Sciences, University of Rome Sapienza, Rome, Italy. stefanopiero.cioffi@ospedaleniguarda.it.
对急性尾炎手术的临床实践指南的遵守率很低,特别是在腹腔灌和抗生素管理方面. 缺乏合规性会增加费用和住院时间,这凸显了干预措施的必要性.
科学领域:
- 紧急的一般外科手术.
- 手术指南的遵守性 手术指南的遵守性
- 附录是管理的管理.
背景情况:
- 紧急通用外科手术 (EGS) 的负担比选择性手术更高.
- 急性尾炎 (AA) 是一种常见的EGS疾病,由临床实践指南 (CPG) 管理.
- 对AA CPGs的遵守是可变的,实施障碍尚未得到充分研究.
研究的目的:
- 探讨遵守AA CPGs的障碍.
- 评估AA管理中CPG不合格的临床经济影响.
主要方法:
- 来自REsiDENT-1注册表 (2019-2022) 的653次腹腔镜尾切除术 (LA) 的分析.
- 从EAES和WSES中识别了7个CPG项目.
- 使用利克尔特尺度和后勤回归来评估合规性,以确定障碍.
主要成果:
- 在腹腔灌 (25.73%),腹腔排水 (34.68%) 和抗生素管理 (34.17%) 中观察到的低合规性.
- 与更高的传染性并发症和更长的住院时间相关的不良遵守 (除了无并发症AA中的PI).
- 由于不遵守规定 (除了复杂的AA中的抗生素管理之外),成本显著上升.
结论:
- 在复杂的 LA 地区,对标准化 AA CPG 的低遵守程度受环境因素和非证据基础的做法的影响.
- 低于最佳的抗生素管理及其对抗生素耐药性的影响令人担忧.
- 结构化的教育干预和机构捆绑是必要的,以改善CPG的遵守.
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