医院资源指数,种族/种族,以及术后静脉血栓塞瘤风险:因果调解分析
Sherene E Sharath1, Grace Shadid1, Justin Chin-Bong Choi1
1Department of Surgery State University of New York, Downstate Health Sciences University, Brooklyn, NY, USA.
American journal of surgery
|August 30, 2024
概括
医院的资源并没有显著降低接受重大腹部手术的黑人患者的静脉血栓栓塞 (VTE) 风险. 其他因素,如生活方式和并发症管理,在减轻VTE风险方面似乎更有影响力.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 外科手术的结果
- 健康差异 在健康上的差异
背景情况:
- 研究了医院资源在种族/种族与术后静脉血栓塞栓症 (VTE) 之间的关联中的作用.
- 使用国家队列进行综合分析.
研究的目的:
- 确定医院资源是否调解了种族/种族和术后静脉瘤之间的联系.
- 了解大腹部手术后静脉瘤风险的差异.
主要方法:
- 分析了癌症患者的大型腹部手术 (1993-2020) 的全国住院样本数据.
- 采用医院资源指数 (大小,教学地位,薪酬组合) 和四向分解后勤回归.
- 定义复合VTE结局为术后深静脉血栓和肺栓塞.
主要成果:
- 总共分析了1,169,862次手术,整体VTE率为1.0%.
- 与白人/白人相比,黑人/非洲裔美国人的VTE风险比白人/白人高出28% (aOR=1.28).
- 增加的医院资源显示,黑人患者的静脉瘤风险略有,但在临床上无意义.
结论:
- 改善医院资源并没有显著有利于处于术后风险的脆弱人群.
- 生活方式,环境因素和并发症管理对于减少VTE风险可能更为关键.
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