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丹麦重大紧急腹部手术后临床结果的趋势,2002-2022年数据
Johanne Gormsen1,2, Dunja Kokotovic1,2, Thomas Korgaard Jensen1,2,3
1Department of Gastrointestinal and Hepatic Diseases, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark.
JAMA surgery
|April 23, 2025
概括
大型紧急腹部手术的结果有所改善,死亡率降低,住院时间缩短. 然而,再接收率显著上升,突显了需要更好的出院后护理的需要.
科学领域:
- 手术结果研究研究.
- 公共卫生监督 公共卫生监督
- 医疗保健服务研究 医疗服务研究
背景情况:
- 大型紧急腹部手术带有相当大的发病率和死亡率风险.
- 了解结果的时间趋势对于确定改进和基准至关重要.
研究的目的:
- 在丹麦进行重大紧急腹部手术后调查发病率和死亡率的趋势.
- 分析二十年来术后并发症和再入院率的变化.
主要方法:
- 在全国范围内,使用丹麦行政登记册 (2002-2022) 进行基于人口的队列研究.
- 包括接受重大紧急腹部手术的成年患者 (腹腔切除/腹腔镜穿孔,缺血,阻塞,,出血).
- 主要结局:30日和90日死亡率的趋势;次要结局:住院时间长度,并发症,再入院.
主要成果:
- 包括超过61,000名患者;每年手术数量保持不变.
- 30日和90日死亡率显著下降 (25%至13%,33%至18%).
- 住院时间减少;然而,30天和90天的再入院率急剧增加 (9%至25%,13%至33%).
结论:
- 在重大紧急腹部手术后观察到的死亡率和住院时间的显著减少.
- 重新入院的显著增加和持续高的并发症率需要加强术后监测和随访.
- 研究结果为未来的研究提供了基准,并突出了手术患者护理领域不断变化的挑战.
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