在接受癌症手术的老年人中,初级保健使用和90天死亡率
Hadiza S Kazaure1, N Ben Neely2, Lauren E Howard3
1Division of Surgical Oncology, Department of Surgery, Duke University, Durham, North Carolina.
JAMA surgery
|August 7, 2024
概括
癌症手术后的初级护理随访改善了老年人的生存率. 在90天内定期进行初级保健访问显著降低了90天术后死亡率,提高了生存率.
科学领域:
- 老年瘤学 老年瘤学
- 医疗服务研究 医疗服务研究
- 外科手术的结果
背景情况:
- 接受癌症手术的老年人面临多病症和术后并发症的高风险.
- 初级保健在优化这些患者的生存中的作用至关重要,但并未得到充分理解.
- 关于老年癌症手术患者的初级保健利用率与生存率之间的关联,数据有限.
研究的目的:
- 调查接受癌症手术的老年人中初级保健使用模式.
- 确定初级保健使用率与90天术后死亡率之间的关联.
主要方法:
- 在2017-2019年接受癌症手术的老年人 (≥65岁) 的回顾性队列研究.
- 根据初级保健医生 (PCP) 的可用性,护理碎片化和术后初级保健访问分层分析.
- 使用反向倾向加权卡普兰-梅尔曲线和日志等级测试评估90天的术后死亡率.
主要成果:
- 在2566名患者中,28.9%缺乏PCP;没有PCP的患者有更高的90天死亡率 (3.6%与2.0%相比).
- 在未碎片化护理的患者中,48.6%的患者在手术后90天内进行初级护理.
- 手术后的初级保健访问与90天死亡率显著降低 (0.3%对3.3%).
结论:
- 在癌症手术后90天内进行初级保健的随访与老年人中改善的生存率有关.
- 确保获得初级保健的癌症后手术可能是提高结果的关键策略.
- 这项研究强调了综合初级保健在老年癌症手术管理中的重要性.
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