在程序内和程序后患者报告的体验指标及其与ERCP后不良事件及其与非计划的医疗保健利用的相关性
Alessandra Ceccacci1, Mehul Gupta2, Maximilian Eisele3
1Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Endoscopy
|September 19, 2024
概括
经过内镜逆行胆血管细胞造影 (ERCP) 后患者报告的腹痛与不良事件和计划外的医疗保健使用有关. 监测疼痛可能有助于预防并发症,并改善ERCP后的患者结果.
科学领域:
- 胃肠病学 胃肠病学
- 患者安全 患者安全
- 临床结果 临床结果
背景情况:
- 随着内镜逆行胆血管细胞造影 (ERCP),不良事件 (AEs) 和计划外的医疗利用 (UHU) 是常见的.
- 患者报告的体验测量 (PREM) 可以在手术期间和之后捕捉患者的症状.
- 评估PREMs与ERCP后结果之间的关联对于改善患者护理至关重要.
研究的目的:
- 研究患者报告的经验测量 (PREM) 和ERCP后不良事件 (AE) 之间的关系.
- 在ERCP后30天内评估PREMs和计划外医疗利用 (UHU) 之间的关联.
- 确定预测AE和UHU的特定PREM领域.
主要方法:
- 从一个多中心的协作中收集未来的数据.
- 应用基于0-10利克特的PREM来评估手术内和后的症状.
- 多变量后勤回归分析以确定PREM领域 (暴露) 和AE/UHU (结果) 之间的关联.
主要成果:
- 术后腹痛得分>3与胰腺炎相关 (OR 3.71),得分>6与穿孔相关 (OR 9.54).
- 较高的术后疼痛分数与30天内UHU增加相关 (OR为1.08分,OR为1.79分>3,OR为1.93分>6).
- 没有其他PREM领域显示与AE或UHU有重大关联.
结论:
- 在ERCP后患者报告的腹痛是胰腺炎,穿孔和UHU的重要预测因素.
- 在出院时使用PREM,特别是疼痛评分,可以帮助识别患有并发症风险的患者.
- 实施PREM监测可以促进早期干预,可能预防UHU,并改善ERCP患者的治疗结果.
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