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复杂性时间,救援失败,住院儿科手术后再入院
Brian T Hickner1, Jorge I Portuondo2, Steven C Mehl3
1Michael E DeBakey Department of Surgery at Baylor College of Medicine, Houston, Texas.
The Journal of surgical research
|August 8, 2024
概括
儿科手术后的术后并发症影响救援失败 (FTR) 和根据时间不同重新入院. 出院前的并发症与FTR有关,而出院后的并发症增加了再接收风险.
科学领域:
- 儿科手术 儿科手术
- 改善外科手术的质量
- 医疗保健服务研究 医疗服务研究
背景情况:
- 手术后并发症与死亡率和再入院有关.
- 与出院相关的并发症的时间及其与未能救援 (FTR) 和儿科手术后再入院的关联尚未得到充分理解.
研究的目的:
- 描述住院儿科手术后相对于出院的并发症的时间.
- 确定并发症时间,FTR和计划外再接收之间的关联.
主要方法:
- 使用NSQIP-儿科数据库 (2012-2019) 进行的国家队列研究.
- 并发症分为排放前,排放后或两者兼而有之.
- 多变量等级回归分析了并发症时间和术后结果之间的关联.
主要成果:
- 在378,551名患者中,8.0%患有术后并发症.
- 与退院前相比,退院后的并发症显示,FTR的几率下降 (OR 0.21),再入院的几率增加 (OR 19.37).
- 出院前和出院后出现的并发症与出院后仅出现的并发症具有相似的FTR和再接收几率.
结论:
- 失败的救援和再接收与相对于出院的不同时间发生的并发症有关.
- FTR主要与出院前的并发症有关,而再接收与出院后的并发症有关.
- 一种"适合所有人"的方法改善外科手术质量可能是无效的;需要量身定制的策略.
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