外科专业化对紧急上部胃肠道手术结果的影响:系统性审查和元分析
Antonio Barbaro1, Zachary Bunjo1, Gayatri Asokan1
1The University of Adelaide, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.
World journal of surgery
|July 2, 2024
概括
在上部胃肠道 (UGI) 紧急手术中的外科子专业化显著降低了30天和住院死亡率. 在紧急情况下,UGI专家的早期参与改善了患者的治疗结果.
科学领域:
- 外科手术 手术手术
- 胃肠病学 胃肠病学
- 公共卫生 公共卫生
背景情况:
- 紧急情况的呈现占整体外科工作负载的很大一部分.
- 紧急手术与较高的死亡率和并发症率有关.
- 上部胃肠道 (UGI) 紧急手术的结果需要集中调查.
研究的目的:
- 评估外科子专业化对紧急上部胃肠道手术患者结果的影响.
- 分析UGI紧急程序中的死亡率和其他关键结果.
- 为了确定专业护理是否能改善这一高风险手术组的结果.
主要方法:
- 在Embase,MEDLINE和Cochrane数据库 (1990-2023) 中进行系统搜索.
- 包括报告30天死亡率,住院死亡率,转换为开放,停留时间长度,返回剧院和再入院的研究.
- 预期在PROSPERO注册 (CRD42022359326) 的情况.
主要成果:
- 从最初确定的5181项中,有7项符合条件的研究.
- 在统计学上显著改善30天死亡率,有利于UGI专家 (OR 0.71).
- 在UGI专家的住院死亡率显著降低 (OR 0.29).
- 转换为开放没有显著差异;返回剧院或再接收的数据不足.
结论:
- 在UGI急诊外科手术中的外科子专业化与改善的死亡率结果有关.
- 建议及早咨询UGI子专家团队,以提高患者的护理.
- 专门的外科专业知识对紧急UGI程序的生存率产生了积极的影响.
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