美国印第安人和阿拉斯加原住民患者之间的急诊与选择性手术差异
Benjamin Brown1, Sarah Holt2, Kassandra Dindinger-Hill1
1Department of Urology, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
World journal of surgery
|March 18, 2024
概括
与非西班牙裔白人相比,美国印第安人和阿拉斯加原住民患者更有可能需要紧急手术,包括关节置换和脊柱融合. 紧急外科护理的这种差异需要进一步调查.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康差异 在健康上的差异
- 外科手术的结果
背景情况:
- 美国印第安人和阿拉斯加原住民 (AIAN) 的人口面临着研究不足的健康问题和较低的预期寿命.
- 紧急手术与术后并发症和死亡率的增加有关.
- 现有的研究突出了AIAN个人在医疗保健获取和结果方面的差异.
研究的目的:
- 确定华盛顿州的美国印第安人和阿拉斯加土著 (AIAN) 患者与非西班牙裔白人 (NHW) 患者相比,需要紧急手术的风险更高.
- 调查AIAN个人常见的手术程序的时间 (紧急与可选) 的潜在差异.
主要方法:
- 利用华盛顿州综合医院摘要报告系统 (CHARS) 2009-2014年的数据.
- 分析了三种常见的手术:关节置换,大动脉置换和脊柱融合.
- 采用多变量逻辑回归来确定与紧急外科护理相关的因素,比较AIAN和NHW患者.
主要成果:
- 与NHW患者相比,AIAN患者的急需关节置换 (OR=1.49),脊髓融合 (OR=1.39) 和大动脉置换 (OR=2.06) 的风险明显更高.
- 与NHW患者相比,AIAN患者在平均年龄较小时接受了这些紧急手术.
- 在所有研究的程序中,医疗补助保险与紧急手术风险增加有关.
结论:
- 与NHW患者相比,AIAN患者不成比例地更有可能接受紧急关节置换,脊髓融合和大动脉置换.
- 在年轻的AIAN患者身上进行紧急外科手术,这表明潜在的潜在因素有助于这一趋势.
- 进一步的研究是必不可少的,以阐明驱动这些差异的具体因素在AIAN人群中的紧急外科护理.
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