在一般和胃肠道外科手术中手术内不良事件的影响:一项全国性的研究
Jefferson A Proaño-Zamudio1, Ikemsinachi C Nzenwa1, May Abiad1
1Division of Trauma, Emergency Surgery & Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
American journal of surgery
|December 12, 2024
概括
在一般外科手术中,手术内不良事件 (IAE) 虽然很少发生,但会显著增加死亡率,并发症和医疗费用. 解决IAEs对于改善外科手术质量和患者结果至关重要.
科学领域:
- 一般外科 整体外科
- 患者安全 患者安全
- 医疗保健的质量 医疗保健的质量
背景情况:
- 在整形外科手术期间发生的手术内不良事件 (IAE) 导致患者的发病率和医疗费用.
- IAE对手术结果和资源利用的全国影响尚不清楚.
研究的目的:
- 确定在整体外科手术中IAE的全国发病率.
- 调查iAEs与住院死亡率,术后并发症,住院时间和医疗保健成本的关联.
主要方法:
- 使用2019年全国再录取数据库进行的回顾性队列研究.
- 包括接受一般外科手术的成年患者.
- IAE的定义是未被识别的腹腔皮层意外刺伤或撕裂.
- 多变量回归分析以评估与结果的关联.
主要成果:
- 在701,866名患者中,0.9%的患者经历了IAE,小肠切除的发病率最高 (2.3%).
- 国际性AEE与更高的住院死亡率 (3.8%与1.5%相比),增加30天的并发症,更长的住院时间和更高的住院费用有关.
- 多变量分析证实iAEs独立与增加的死亡率,停留时间,再入院和各种并发症 (例如败血症,手术部位感染) 相关.
结论:
- 术后不良事件与严重增加的并发症和医疗利用率有关,尽管其发生率低.
- 建议包括将IAE纳入外科手术质量改进计划,并为IAE建立标准化报告.
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