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德贝基VA医院的多学科截肢预防:我们的第一个十年
Neal R Barshes1,2, Aimee D Garcia1,2, Cezarina Mindru1,2
1Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.
概括
在退伍军人卫生管理局实施跨学科护理,在2012年至2017年期间,大大降低了腿部截肢率的60%. 这种方法在预防高风险退伍军人患者截肢方面被证明是有效的.
科学领域:
- 这是血管外科手术.
- 足部医学是一门专业.
- 医疗保健管理的管理
背景情况:
- 退伍军人卫生管理局 (VHA) 在2011年启动了多学科计划,以加强对不愈合的脚的护理.
- 这些努力旨在降低退伍军人中下肢截肢率.
研究的目的:
- 评估跨学科护理模式对VHA系统内截肢预防的影响.
- 评估协调方法在管理退伍军人的复杂足部疾病方面的有效性.
主要方法:
- 使用内部注册表对VHA患者群体的表征.
- 使用德克萨斯州医院入院数据,与性别和邮政编码匹配的非退伍军人队伍进行了比较.
- 分析国家和地方截肢频率和VHA内的糖尿病流行数据.
主要成果:
- 在VHA医院接受治疗的退伍军人年龄较大,更有可能是黑人,与匹配的非退伍军人相比,糖尿病,慢性脏病和心力衰竭的发病率更高.
- 从2012年到2017年,跨学科护理的实施与截肢率减少了60% (从每10万人中160人降至66人).
- 在研究期间,对于足部或炎进行的血管图的比例从28.9%大幅增加到90.9%.
结论:
- 跨学科护理是一种高效的策略,可显著降低退伍军人中腿部截肢率.
- 这种方法在截肢预防方面的成功似乎独立于特定的住院护理提供模式.
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