同一天出院的安全结果 解剖手术代谢/腹腔外科 vs 常规夜间出院协议:系统性审查和元分析
Patricia M Ortega1, Lucas Sabatella2, Ahmed R Ahmed3,4
1Imperial College Healthcare NHS Trust, London, United Kingdom. pmtnezortega@gmail.com.
Obesity surgery
|May 20, 2025
概括
在代谢和减肥手术 (MBS) 中,同日出院 (SDD) 与夜间住院 (OH) 相比,增加了死亡和发病风险. 谨慎的患者选择和协议标准化对于在MBS中安全实施SDD至关重要.
科学领域:
- 腹部外科 腹部外科
- 外科手术的结果
- 优化医疗保健的优化
背景情况:
- 同一天出院 (SDD) 协议越来越多地被采用在代谢和腹部手术 (MBS) 中,以优化医疗保健资源.
- 人们仍然担心SDD的安全性,特别是死亡率和术后并发症.
研究的目的:
- 为了比较SDD的安全性与异位性MBS的标准夜间住院 (OH).
- 评估早期的术后结果,包括死亡率,发病率,再入院率和再手术率.
主要方法:
- 按照PRISMA和MOOSE指南进行了系统审查和元分析.
- 分析了四项涉及19,849名患者 (24.4%SDD) 的研究.
- 结果包括30天的发病率,死亡率,再入院,重新手术和Clavien-Dindo并发症;使用了一个随机效应模型.
主要成果:
- 与OH相比,SDD与30天死亡率 (OR 7.24) 和整体发病率 (OR 1.89) 的风险显著更高.
- 在再接收率 (OR 1.17) 或重新操作率 (OR 0.98) 中没有发现显著差异.
- 值得注意的是,SDD显示严重并发症的发生率明显较低 (Clavien-Dindo等级III/IV) (OR 0.64).
结论:
- 与SDD相关的死亡率和发病率增加凸显了严格的患者选择和标准化协议的必要性.
- 强大的后续系统对于在MBS中安全实施SDD至关重要.
- 需要进一步的前性研究来完善SDD协议以确保安全应用.
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