针对恶性胃出道阻塞的息性干预措施的国家视角
Ayesha P Ng1, Joseph E Hadaya1, Yas Sanaiha1
1Department of Surgery, David Geffen School of Medicine at the University of California, Los Angeles, CA, United States.
概括
对于恶性胃出口阻塞 (GOO) 的内镜支架 (ES) 提供了与胃支架 (GJ) 相似的结果,但显著降低了成本和停留时间. 这表明ES可能是GOO更有效的治疗选择.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 胃出口阻塞 (GOO) 影响15-20%的十二指肠或周围腹膜恶性瘤患者.
- 之前的小型试验表明,内镜支架 (ES) 提供比手术胃支架 (GJ) 更快的恢复,但国家一级的数据有限.
研究的目的:
- 通过使用国家数据库,比较恶性GOO的ES与GJ的短期临床和财务结果.
- 评估这两种息性干预措施的死亡率,并发症,停留时间,成本和再接收率.
主要方法:
- 来自2016-2020年全国再接收数据库的恶性GOO成年患者的分析.
- 用平衡和多变量回归来比较ES和GJ组之间的结果.
- 评估的关键结果包括住院死亡率,TPN使用,并发症,LOS,成本和90天再入院.
主要成果:
- 在8186名患者中,68.4%接受了ES,31.6%接受了GJ. GJ患者更常常是脆弱的.
- 经过风险调整后,ES和GJ之间的死亡率,并发症和90天再入院是相似的.
- GJ与更高的输血几率,TPN使用,成本增加 (>15,800美元) 和更长的LOS (>6.9天) 相关.
结论:
- 内镜支架 (ES) 在恶性GOO的治疗中提供了与肠胃支架 (GJ) 相似的短期结果,并节省了大量的成本.
- 改善对内镜技术的访问和集中在高体积中心的护理可能会改善恶性GOO患者的治疗结果.
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