在复杂尾炎的非手术治疗后,间隔尾切除术前非计划性再入院率
Zane J Hellmann1, Shahyan Rehman, Matthew Hornick
1From the Division of Pediatric Surgery, Yale New Haven Children's Hospital, New Haven, CT.
Journal of the American College of Surgeons
|December 10, 2024
概括
对于非手术治疗的复杂尾炎,在初始治疗后的前50天内,尾炎复发的风险最高. 延迟间隔尾切除术可能会降低儿科患者的再入院率.
科学领域:
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
- 临床结果研究研究
背景情况:
- 临床均衡存在关于前期尾切除与复杂尾炎的非手术治疗.
- 在儿童非手术治疗后,尾炎的自然史和复发风险尚不清楚.
- 根据从初始治疗开始的时间来理解再接收率对于临床决策至关重要.
研究的目的:
- 在儿科患者的非手术治疗后,描述尾炎复发的风险.
- 为了确定从索引录取时间到计划外再录取率之间的关系.
- 为了告知有关间隔尾切除术时间的共享决策.
主要方法:
- 使用儿科健康信息系统 (2018-2021) 进行回顾性队列研究.
- 包括年龄小于18岁的患有复杂尾炎的患者,在没有立即尾切除的情况下连续3天以上接受抗生素治疗.
- 卡普兰-梅尔分析评估了随着时间的推移而发生的非计划性再接收率.
主要成果:
- 分析了2826名患有尾炎并发症的患者,810人接受了非手术治疗.
- 从索引录取延迟每增加一天,意外再录取率下降7% (HR 0.93).
- 在入院后的50-100天 (HR 2.31) 相比,在前50天的再入院率是入院后50-100天的两倍.
结论:
- 在非手术治疗后的复发性尾炎或并发症的最高风险发生在初次入院后的前50天内.
- 这些发现支持基于个性化风险评估的时间间隔尾切除术讨论.
- 延迟间隔尾切除术可能与儿科患者再入院风险降低有关.
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