肠道紧急情况的手术和非手术管理:单中心回顾性队列研究的发现
A R Darbyshire1, I Kostakis1,2, P Meredith1
1Portsmouth Hospitals University NHS Trust, UK.
Annals of the Royal College of Surgeons of England
|December 1, 2023
概括
许多肠道急诊患者避免手术,非手术治疗的停留时间较短,但30天死亡率翻了一番. 这凸显了非手术性肠道紧急管理的风险.
科学领域:
- 胃肠病学 胃肠病学
- 外科手术的结果
- 医疗信息学 医疗信息学
背景情况:
- 肠道紧急情况往往需要手术干预.
- 对肠道紧急情况的非手术性管理的结果没有得到很好的描述.
- 电子健康记录提供了一个快速分析患者数据的资源.
研究的目的:
- 确定非手术治疗肠道紧急情况的患者比例.
- 为了比较非操作和操作管理策略之间的短期结果.
- 确定影响管理决策和结果的患者特征.
主要方法:
- 在NHS第三级医院进行的回顾性队列研究 (2013-2020).
- 通过肠道紧急情况的诊断代码来识别患者.
- 从3,997名患者的电子健康记录中提取数据.
主要成果:
- 43.7%的患者接受了非手术治疗.
- 非手术组的住院时间较短 (5.4天),而非手术 (8.2-16.8天).
- 与手术 (10.1%) 相比,非手术治疗的30天死亡率更高 (22.4%).
结论:
- 很大一部分肠道紧急情况是通过非手术方式进行的.
- 虽然非手术护理可能导致住院时间缩短,但与30天死亡率更高有关.
- 谨慎的患者选择对于非手术性肠道紧急管理至关重要.
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