分析需要医院间转移的减肥手术并发症,使用修改后的维多利亚手术死亡率审计框架
Yit J Leang1,2, Richard Chen1,2, Kalai Shaw1,2
1Oesophago-gastric and Bariatric Surgical Unit, Department of General Surgery, The Alfred Hospital, VIC, Australia.
ANZ journal of surgery
|August 16, 2024
概括
对于减肥手术并发症的医院间转移 (IHT) 需要付出相当大的成本和患病率. 客观的审查框架可以识别可预防的因素,并通过结构化的反来改善患者的结果.
科学领域:
- 手术成果研究的研究结果.
- 医疗保健系统分析分析
- 患者安全倡议 患者安全倡议
背景情况:
- 手术审计对于维持护理标准至关重要.
- 现有的审计可能无法完全捕捉医院间转移 (IHTs) 期间的患者发病率.
- 在IHT中评估临床问题需要强大的方法.
研究的目的:
- 评估一个客观的框架对IHTs临床问题的评估的实用性.
- 确定导致腹外科手术发病率的关键因素 IHTs.
- 确定并发症和沟通缺口的可预防性.
主要方法:
- 在2014-2021年期间转移的减肥手术患者的回顾性队列研究.
- 通过修改的德尔菲程序开发的客观框架的应用,用于案例审查.
- 使用权重的科恩卡帕系数评估观察者间的一致性.
主要成果:
- 包括73名患者;近端主干线泄漏是最常见的转移指示.
- IHT与长时间停留和高成本有关.
- 转移/识别的延迟,人/患者因素和可预防的并发症被确定;反往往缺乏.
结论:
- 腹症并发症的IHTs具有显著的发病率和成本.
- 结构化审查框架可以确定可修改的因素以改善结果.
- 为转诊临床医生提供建设性的反和记录是必不可少的.
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