结肠癌切除术后的早期出院:一个国家视角
Arjun Verma1, Syed Shahyan Bakhtiyar1,2,3, Konmal Ghazal Ali1
1Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California, United States of America.
对癌症进行切除术后的早期出院是安全且具有成本效益的. 这项大型研究发现,快速出院减少了4,500美元的费用,并降低了再入院率,而不会增加中风风险.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 卫生经济学 卫生经济学
- 患者的治疗结果.
背景情况:
- 目前,缺乏对经过小肠切除术后早出院的现代大规模分析.
- 由于潜在的成本节约和改善患者流动,提前出院具有显著的兴趣.
研究的目的:
- 为了检查用于初级结肠癌的胆管切除术后早出院后的费用和再接收.
- 在国家队列中评估提前释放的安全性和成本效益.
主要方法:
- 利用了2016-2019年全国再接收数据库,用于为结肠癌进行选择性切除术的成年患者.
- 排除了患有术后并发症或长时间停留 (>8天) 的患者.
- 在术后第3天出院的患者被分类为"早期"和其他患者被分类为"常规",使用平衡和多变量回归来分析结果,包括90天中风率.
主要成果:
- 早期队列 (45.5%) 较年轻,更常见的是男性,并接受了更多的左侧和腹腔镜切除术.
- 加快出院与4500美元的成本降低以及较低的30天和90天非选举性再录取相关 (AOR为0.74).
- 早出院患者的胃肠道疾病再入院率较高,但90天中风率相似 (2.2%对2.1%).
结论:
- 针对癌症的切除术后的早期出院是相对安全和经济有效的.
- 这项研究是迄今为止最大规模的分析,支持加速放电协议.
- 研究结果表明,有可能优化胆管切除术护理途径.
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