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恶性肠道阻塞的缓解干预需要付出代价:一项全国性住院患者研究
Beatrice J Sun1, Lakshika Tennakoon2, David A Spain2
1Surgical Oncology, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
The American surgeon
|May 23, 2024
概括
来自腹腔癌 (PC) 的恶性肠道阻塞 (MBO) 的治疗包括非手术,手术或手术选择. 程序和手术干预增加了医院费用和住院时间,使用资源和死亡率的趋势更高.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 抚慰性护理是一种缓解性护理.
背景情况:
- 由于腹癌 (PC) 的恶性肠道阻塞 (MBO) 显著影响患者的结局.
- 目前MBO的最佳息管理策略仍未确定.
- 本研究探讨了MBO的非操作,程序和操作方法.
研究的目的:
- 描述PC患者MBO的管理策略.
- 评估MBO管理与患者死亡率之间的关联.
- 评估不同MBO治疗方式的经济影响.
主要方法:
- 使用了来自2018-2019年国家住院患者样本 (NIS) 的ICD-10代码.
- 从胃肠道或卵巢初级检查中识别了MBO与PC的患者入院情况.
- 将管理分类为非手术,程序或手术;使用多变量分析分析死亡率和成本的关联.
主要成果:
- 确定了356,316名MBO入学者;平均年龄为63.
- 手术管理与最长的停留时间 (17天) 与手术 (14天) 和非手术 (7天) 相对相关.
- 程序和手术组的住院费用,出院后的需求,息护理咨询和康复入院费用较高,死亡率增加 (9%和8%,而非手术患者为7%).
结论:
- 对手术和手术MBO治疗的入院与住院时间的延长,医院费用和出院需求有关.
- 对MBO的最佳管理仍然很复杂,需要仔细考虑所有缓解方案.
- 更高的资源利用率和死亡率趋势表明需要重新评估息干预策略.
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