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在胰腺手术中,手术对住院结果的周日影响:基于人口的研究

Konstantin Uttinger^1,2, Annika Niezold³, Lina Weimann³

¹Department of Visceral, Transplant and Thoracic Surgery, Frankfurt am Main University Medical Center, Theodor- Stern-Kai 7, 60596, Frankfurt am Main, Germany. konstantin@uttinger.com.

Langenbeck's archives of surgery

|December 12, 2024

概括

手术的周日会影响胰腺切除的结果. 周一的手术显示出更高的并发症率和救援失败率 (FtR),特别是在体积较小的医院.

科学领域:

手术结果研究研究.
医疗保健服务研究医疗服务研究
在瘤学瘤学.

背景情况:

在复杂的腹部手术中,如胰腺切除,存在相互矛盾的证据,这些结果取决于工作日.
了解这些变化对于优化患者护理和资源配置至关重要.

研究的目的:

在全面的全国范围内调查胰腺切除后结果的周日依赖性.
分析指数手术的每周一天与并发症发生和救援失败 (FtR) 之间的关联.

主要方法:

使用德国 (2010-2020年) 全国匿名医院计费数据 (DRG数据) 的回顾性横截面研究.
分析包括94,661个患者记录,其中包含胰腺切除的程序代码.
主要终点是并发症发生和救援失败 (FtR),定义为并发症后的死亡率,按指数手术的周日分层.

主要成果:

在周一指数手术后,并发症发生率 (67.6%) 和FTR (12.6%) 最高.
与周一相比,FtR在周三 (调整后的OR,0.92) 和周四 (调整后的OR,0.89) 的指数手术中明显较低.
对并发症和FTR的周日依赖性主要在低体积的医院观察到.

结论:

胰腺切除是高风险的程序,具有显著的并发症率和FTR.
指数手术的周日影响并发症发生率和FTR,影响整体住院死亡率.
这种平日效应在体积较小的手术中心尤为明显,凸显了对量身定制方案的需求.

关键词:

发生并发症的发生.没有救援的失败.住院死亡率住院死亡率在胰腺外科手术中,周日效应周日效应

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