在脊椎手术后的术后种族差异在门诊环境中不那么明显
Troy B Amen1, Izzet Akosman1, Tejas Subramanian1
1Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.
概括
脊椎手术结果的种族差异仍然存在,黑人患者在住院手术中面临更高的并发症率. 然而,这些差异在门诊环境中不那么明显,这表明随着护理转移,改善公平的潜力.
科学领域:
- 神经外科 神经外科
- 健康 公平 卫生 公平
- 外科手术的结果
背景情况:
- 住院脊柱手术中的种族差异已经得到了充分的证据.
- 门诊脊椎手术正在增加,但种族结果差异尚不清楚.
研究的目的:
- 为了比较黑人和白人患者进行门诊 (OP) 和住院 (IP) 脊椎手术的术后结果.
- 为了确定不良事件,再入院,再手术和死亡率的种族差异.
主要方法:
- 使用国家外科质量改进计划 (NSQIP) 数据库 (2017-2021) 的回顾性队列研究.
- 在IP和OP设置中分析了微隔膜切除术,细膜切除术,ACDF和CDR的结果.
- 使用多变量后勤回归来调整人口和临床因素.
主要成果:
- 在IP手术后,黑人患者的不良事件,再入院,再手术和非家庭出院的几率更高.
- 在OP设置中,与白人患者相比,黑人患者的再入院几率更高,但其他不良事件的发生率相似.
- 在IP设置中观察到显著的种族差异,但在OP设置中不那么突出.
结论:
- 在脊柱手术并发症中存在种族差异,特别是在住院患者的环境中.
- 门诊脊椎手术显示,减少了,虽然没有消除,种族结果差异.
- 将脊柱护理转移到门诊机构可能有机会减轻种族不平等.
更多相关视频
相关概念视频
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
88
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
88
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
632
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
632