术前危险因素对日间手术中延迟出院的影响:元分析
Hanqing Zhang1,2, Xinglian Gao1, Zhen Chen3
1Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
Healthcare (Basel, Switzerland)
|January 25, 2025
概括
确定关键的手术前风险因素,如年龄,BMI,并发症,麻醉类型,心脏病史,性别,手术持续时间,复杂性,社会支持和评估质量,对于及时的日间手术出院至关重要. 解决这些因素可以提高患者的治疗结果和外科手术的效率.
科学领域:
- 外科手术患者管理
- 医疗保健系统分析 医疗保健系统分析
- 基于证据的医学基于证据的医学.
背景情况:
- 日间手术在全球越来越普遍,使得及时的患者出院成为一个重大挑战.
- 之前的研究已经确定了延迟出院的各种手术前风险因素.
- 这次元分析综合了现有证据,以确定主要的手术前风险因素.
研究的目的:
- 评估和识别影响日间手术患者及时出院的关键手术前风险因素.
- 为改善手术前评估和尽量减少延迟出院提供证据.
- 提高日间手术程序的效率和安全性.
主要方法:
- 在七个主要数据库 (PubMed,CINAHL,Scopus,Web of Science,Embase,Cochrane Library,CNKI) 进行了系统的文献搜索.
- 包括研究集中在日间手术的术前风险因素,发表到2024年10月15日.
- 数据被汇总并使用系统审查和随机效应模型进行分析.
主要成果:
- 分析了9项涉及41,458名患者的研究.
- 延迟出院的重大风险因素包括:年龄较大,BMI较高,慢性并发病,特定类型的麻醉,心脏病史,女性性别,更长的手术持续时间,复杂的手术,缺乏社会支持和不充分的手术前评估.
- ASA分类和手术前焦虑没有显示出统计学上显著的差异.
结论:
- 影响日间手术出院的关键手术前因素包括年龄,BMI,并发症,麻醉,心脏病史,性别,手术持续时间,手术复杂性,社会支持和评估质量.
- 这些发现为手术前风险评估提供了有价值的参考.
- 在查和管理过程中,对高风险患者的临床关注可以减少延迟出院并改善外科手术结果.
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