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医院间转移状态与非创伤性腹腔内出血后的结果之间的关联
Yusuf A Mehkri1, Grace Hey1, Cathleen C Kuo2
1University of Florida College of Medicine, Gainesville, FL, United States.
概括
对于非创伤性腹腔内出血 (ntSDH) 的医院间转移 (IHT) 与术后后果更差,包括更高的败血症和死亡率有关. 没有转移的患者经历了脏问题和再入院的增加.
科学领域:
- 神经外科 神经外科
- 创伤外科 手术 创伤外科
- 医疗保健管理的管理
背景情况:
- 非创伤性腹腔内出血 (ntSDH) 往往需要转移到专门的中心.
- 社区医院可能缺乏用于立即手术干预的资源.
- 医院间转移 (IHT) 是需要高级护理的ntSDH患者的常见途径.
研究的目的:
- 评估医院间转移 (IHT) 对非创伤性腹腔内出血 (ntSDH) 患者的术后并发症和结果的影响.
- 为了比较接受IHT和在初始医院接受治疗的患者之间的结果.
主要方法:
- 使用国家外科质量改进计划 (NSQIP) 数据库 (2014-2020).
- 分析了根据IHT状态分层的基线人口统计,临床特征和术后结果.
- 进行了单变量和多变量逻辑回归来确定效应大小 (OR,95% CI).
主要成果:
- 在715名患者中,41.3%属于IHT队列.
- 非IHT患者患有更高的进展性功能衰竭和30天再入院率.
- IHT与术后败血症 (OR=1.37),30天死亡率 (OR=1.20) 和非家庭处置 (OR=1.14) 的几率增加有关.
结论:
- 转移为ntSDH治疗的患者面临着更糟糕的术后结果,尽管基线特征相似.
- 需要进一步的研究来确定有助于IHT后不良结果的特定因素.
- 了解这些因素可以指导策略,以减轻与ntSDH患者转移相关的风险.
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