疾病病因和胆管切除术的适用性对术后结果的影响:NSQIP胆管切除术向数据库研究
Sourav K Podder1, Allison Doermann1, George Ibrahim1
1From the Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA (Podder, Doermann, Ibrahim, Koeneman, Schleider, Shindle, Cowan, Yeo, Hanna).
Journal of the American College of Surgeons
|January 14, 2025
概括
结肠切除术的指示会影响患者的治疗结果. 与结肠癌或传染病相比,炎症性肠病 (IBD) 患者在手术后的患病率和并发症较高,这凸显了需要量身定制的质量举措的需要.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 手术结果研究研究.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 美国外科医生学院 (ACS) 的NSQIP大肠切除向数据库提供了手术结果指标.
- 目前的 ACS NSQIP 报告缺乏分层分层,以采集术为指示.
- 这项研究比较了不同胆管切除术指示的结果.
研究的目的:
- 为了比较30天的手术后结局,科切除术患者.
- 根据指示分析结果:结肠癌,传染病或炎症性肠病 (IBD).
- 通过根据疾病病因学分层结果,为质量改进计划提供信息.
主要方法:
- 从ACS NSQIP Colectomy-Targeted数据库中对科切除术患者 (2012-2022) 的回顾性审查.
- 后勤回归模型用于比较30天的术后结果.
- 经手术前风险因素调整后的结果.
主要成果:
- 分析了158,560例结肠癌,90,827例感染性原因,以及30,548例IBD切除术.
- 未经调整的分析显示,感染原因的死亡率和发病率最高.
- 调整后的分析显示,与结肠癌和传染病因相比,IBD患者的发病率 (OR 1.3) 显著更高.
- IBD患者的风险增加了VTE,SSI,长时间的内脏和再入院.
结论:
- 结肠切除术的指示显著影响术后的结果.
- 根据疾病病因学报告风险调整的结果至关重要.
- 分层报告可以识别高风险患者并指导有针对性的质量改进工作.
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