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在儿童胃口管插入后确定质量改进目标:NSQIP-儿科试点研究
Anoosha Moturu1, Melvin Coleman2, Catherine Mets2
1American College of Surgeons, Division of Research and Optimal Patient Care, Chicago, IL, USA; Stanford Healthcare, Stanford, CA, USA.
Journal of pediatric surgery
|January 1, 2025
概括
儿科胃口管 (GT) 放置显示了手术前成像的显著变化和高率的术后并发症,如移位和急诊. 标准化护理可以改善需要GT的儿童的治疗结果.
科学领域:
- 儿科手术 儿科手术
- 改善外科手术的质量
- 医疗保健数据分析数据分析
背景情况:
- 胃口管 (GT) 放置是一种常见的儿科外科手术程序.
- 缺乏GT护理流程和发病率的国家注册表,阻碍了质量评估.
- 美国外科医生学院国家外科质量改善计划-儿科 (ACS NSQIP-Ped) GT试点成立,以收集相关数据.
研究的目的:
- 分析儿科GT手术的外科手术期间实践的变化.
- 确定与儿科GT安置相关的术后发病率和类型.
- 提供数据以指导未来的质量改进 (QI) 干预和研究.
主要方法:
- 对ACS NSQIP-Ped数据库 (2023) 的回顾性队列分析.
- 包括接受GT安置的儿科患者 (0-17岁).
- 检查了手术前的上部胃肠道 (UGI) 研究利用率和术后的结果 (例如,急救室访问,GT脱).
主要成果:
- 在NSQIP-Ped数据库中,GT安置占所有儿科手术的5.3%.
- 参与的试点医院提交了57%的GT病例,其中77%是首次安置.
- 术前UGI研究的利用率差异很大 (0-99%),总体使用率为45%. 术后发病率包括14%的急救诊所和5.2%的GT脱落.
结论:
- 在手术前UGI研究中,用于儿科GT安置,存在显著的医院间变异性.
- 观察到高 postoperative 发病率,包括急诊室访问和 GT 脱落.
- 研究结果强调需要标准化的临床实践,以减少并发症和改善儿科GT护理.
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