被忽视的因素:残疾对紧急整体外科手术后术后并发症的影响
Wardah Rafaqat1, Emanuele Lagazzi1, May Abiad1
1Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Surgery
|March 13, 2024
概括
患有残疾的患者经历了更糟糕的手术结果,包括更高的再入院率和更长的住院时间. 这凸显了接受手术的残疾人医疗保健的巨大差异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 外科手术的结果
- 健康差异 在健康上的差异
背景情况:
- 关于残疾如何影响手术患者护理和结果的研究有限.
- 美国有超过6100万个残疾人,但他们的外科医疗保健差异没有得到充分研究.
研究的目的:
- 为了研究残疾对一般外科病人的术后结果的影响.
- 识别残疾手术患者所面临的具体差异.
主要方法:
- 使用全国再接收数据库 (2019) 的回顾性队列研究.
- 与18岁以上的紧急普通外科手术患者进行了比较,患者有或没有残疾 (根据CDC标准定义).
- 根据患者,手术和医院的特点进行1:1的倾向匹配.
主要成果:
- 1.6%的患者患有残疾,通常与较低的收入和较高的并发症得分有关.
- 残疾患者的30天再入院率 (17.2%对12.7%) 和传染性并发症 (29.8%对19.5%) 显着更高.
- 残疾与更长的住院时间 (8天而不是6天) 有关,运动障碍显示出最显著的影响.
结论:
- 严重的障碍 (智力,听力,视觉,运动) 与重新入院,发病率和延长住院时间的增加相关.
- 这些发现强调了手术后残疾患者的显著差异.
- 进一步的研究对于阐明潜在机制和制定有针对性的干预措施至关重要.
相关概念视频
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
80
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...
80
01:29Appendicitis-II: Diagnostic Studies and Management
80
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
80
01:24General Anesthesia: Overview
216
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
216