基于人口的儿科尾炎手术内疾病严重性标准
Kerri A McKie1, Donne A Graham2, Shannon L Cramm3
1Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
JAMA surgery
|July 3, 2024
概括
国家外科质量改善计划 (NSQIP) 复杂尾炎的儿科标准的存在和数量与儿童更多的术后并发症和更多的资源使用有关. 这些标准为风险评估提供了基于证据的框架.
科学领域:
- 儿科手术 儿科手术
- 改善外科手术的质量
- 医疗保健研究成果 研究成果
背景情况:
- 需要一种标准化的方法来评估儿童尾炎的严重程度,以准确预测结果和比较绩效报告.
- 国家外科质量改善计划 (NSQIP) 儿科为复杂的尾炎提供了手术内标准.
研究的目的:
- 调查NSQIP 儿科内科手术标准对复杂尾炎和患者结局之间的关联.
- 确定这些标准的数量是否与不良事件和资源利用相关.
主要方法:
- 一项使用NSQIP儿科尾切除术程序的队列研究,针对性和一般参与者使用数据文件.
- 包括在2019年至2022年期间在148家NSQIP儿科参与医院接受尾切除手术的18岁以下儿童.
- 根据患者特征调整的多变量回归分析,以评估手术内标准对结果的影响.
主要成果:
- 在82,950名患者中,有27.9%的人至少有一个复杂尾炎的标准.
- 每一个标准 (可见的穿孔,,便,排泄物) 独立地与更高的不良事件率有关.
- 越来越多的标准表明,不良事件和资源使用的风险逐步增加.
结论:
- 复杂尾炎的NSQIP儿科标准的存在和数量与术后并发症和资源使用增加有显著联系.
- 这些标准代表了一个强大的,以证据为基础的框架,用于评估儿科尾炎的严重程度.
- 采用这些标准可以改善风险分层和医院绩效评估.
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