在手术治疗脚骨折后术后X射线的有效性:它们的作用是什么?
Vivek Nair1, Vikranth Mirle2, Kelly Hynes2
1Beaumont Hospital Royal Oak Department of Orthopaedic Surgery, USA; UChicago Medicine Department of Orthopaedic Surgery and Rehabilitation Medicine, USA.
Injury
|May 4, 2024
概括
无症状患者的常规X射线手术治疗脚骨折很少改变管理. 这项研究建议重新考虑常规监视成像,以减少成本和患者负担.
科学领域:
- 整形外科手术 整形外科手术
- 放射学 放射学是一门学科.
- 卫生经济学 卫生经济学
背景情况:
- 在经过手术治疗的脚骨折的无症状患者中,例行术后成像的临床效用尚未得到充分证实.
- 目前的做法往往涉及常规监控X射线,尽管益处不明确.
研究的目的:
- 评估手术后X射线在经过手术治疗的脚骨折的临床无症状患者中导致管理变化的频率.
- 评估无症状监视成像的成本效益.
主要方法:
- 一项回顾性队列研究分析了1级创伤中心的193名手术治疗脚骨折的患者的438张术后X射线.
- X射线被归类为监视或临床指示. 管理变化被定义为随访的改变,规程的偏离或修复手术.
- 进行了后勤回归和成本分析.
主要成果:
- 在391次监测X射线中 (在无症状患者中进行) 只有5次导致管理变化.
- 临床指示的X射线显著更有可能改变管理 (p < 0.0001).
- 无症状监测X射线的年度成本为21,825.62.62美元.
结论:
- 在无症状患者中,手术治疗脚骨折的术后放射图对改变患者护理的收益率很低.
- 常规监控成像导致医疗保健费用,患者的时间和无显著临床益处的辐射暴露.
- 未来的方案应平衡早期并发症检测,尽量减少不必要的成像,考虑个性化的患者因素.
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