在小儿大手术中改善术后结果:来自医院体积分析的证据
Mingyang Sun1, Wan-Ming Chen2,3, Szu-Yuan Wu4,5,6,7,8,9,10,11,12
1Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China.
European journal of pediatrics
|November 9, 2023
概括
在大量医院接受重大手术的儿科患者出现的并发症较少,死亡风险更低. 这突显了专门的儿科手术中心对于更好的患者结果的好处.
科学领域:
- 儿科手术 儿科手术
- 医疗保健服务研究 医疗服务研究
- 外科手术的结果
背景情况:
- 关于医院体积和儿科手术结果之间的联系的证据有限.
- 了解这种关系对于优化儿科手术的护理和资源配置至关重要.
研究的目的:
- 调查医院手术体积与儿科大手术术术后结果之间的关联.
- 分析医院容量对手术后30天和90天内死亡率和重大并发症的影响.
主要方法:
- 利用了全国范围的儿科患者的数据库,这些儿科患者接受了重大选择性住院手术.
- 分析了30天和90天的术后结果,包括死亡率和主要并发症,按医院体积分层 (低,中,高).
主要成果:
- 医院体积组之间30天术后死亡率没有显著差异.
- 中型和高容量医院的30天主要并发症率明显较低,特别是深部伤口感染.
- 大批量医院的90天死亡率和重大并发症率 (深度伤口感染,肺炎,败血症) 显著降低.
结论:
- 在中型和高容量医院接受重大手术的儿科患者在重大并发症方面经历了更好的结果.
- 高医院人数与降低死亡率和重大并发症风险有关,强调了专门的儿科外科中心的重要性.
- 研究结果支持制定医院选择指南,以改善儿科手术结果,并为卫生政策提供信息.
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