结直肠外科手术中的"教科书结果":系统性审查和元分析
Benjamin M Mac Curtain1, Wanyang Qian2, Aaron O'Mahony3
1Department of Urology, St Vincent's University Hospital, Dublin, Ireland. b.m.maccurtain@gmail.com.
Irish journal of medical science
|July 10, 2024
概括
教科书结果 (TO) 在55%的外科病例中实现,但定义各不相同. 标准化这种综合测量对于未来的比较和更好地预测患者的结果至关重要.
科学领域:
- 手术成果研究的研究结果.
- 医疗服务研究 医疗服务研究
- 临床有效性 临床有效性
背景情况:
- 教科书结果 (TO) 是评估外科手术术后结果的综合指标.
- 目前的证据缺乏关于外科医生用于TO和实现TO率的元素合成.
研究的目的:
- 系统地审查和元分析影响教科书结果 (TO) 和外科患者TO成就率的因素.
- 确定实现TO的预测因素,并调查其定义和应用的变化.
主要方法:
- 按照PRISMA指南进行系统审查和元分析.
- 在PubMed,EMBASE和Cochrane中央注册表中搜索到2023年11月8日.
- 分析了TO的整体比例,临床因素和风险因素.
主要成果:
- 包括15项研究 (301,502名患者) 进行审查和14项研究 (247,843名患者) 进行元分析.
- 聚合TO的成绩率为55% (95%CI 54-55%),选修 (56%) 和混合 (54%) 案件负载的比例相似.
- 在TO定义中观察到显著的异质性;年龄,左侧手术和选择性手术被确定为预测因素.
结论:
- 教科书结局 (TO) 在55%的病例中实现,并且可以预测患者的结果.
- 选择性和混合案件负载之间的TO率没有显著差异.
- 缺乏标准化的TO定义阻碍了有意义的比较;建议进行标准化和Delphi共识.
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