澳大利亚新南威尔士州性结肠炎的全 (直) 切除术后结果的意想不到变化:基于人口的19年链接数据研究
Hugh L Giddings1,2,3, Kheng-Seong Ng1,2,4, Michael J Solomon1,2,3,4
1Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
概括
在新南威尔士州接受全肠切除术的性结肠炎 (UC) 患者的结果在国际上是可比的. 公立医院的高死亡率与患者病例组合有关,而不仅仅是手术量.
科学领域:
- 胃肠病学 胃肠病学
- 外科手术的结果
- 公共卫生 公共卫生
背景情况:
- 性结肠炎 (UC) 的整体 (procto) 切除术是一种具有显著发病率的大型手术.
- 与选择性手术相比,紧急大肠切除术的风险更高.
研究的目的:
- 在澳大利亚新南威尔士州 (NSW) 评估UC的总 (procto) 切除术的结果.
- 确定影响结果的患者和医院因素.
主要方法:
- 对新南威尔士州1418名UC患者 (2001-2020年) 的回顾性数据链接研究.
- 主要结局:90天死亡率.
- 后勤回归用于评估患者人口统计和医院因素的影响,包括年度量.
主要成果:
- 整体90天死亡率为3.2% (紧急情况8.6%,选择性0.8%).
- 随着年龄的增长,并发病率的增加,公共保险,紧急手术和非大都市居住而增加的死亡率.
- 在多变量分析中,医院体积不是死亡率的重要独立预测指标.
结论:
- 新南威尔士州UC整体切除术的结果与国际基准一致.
- 较低体积和公共医院的死亡率较高,归因于病例组合和患者急性.
- 缺乏集中的IBD手术和因保险和地点而异的结果差异表明,在获得专业护理方面存在潜在的不平等.
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