高级实践提供者协会在胰腺外科手术中整合术后结果
Evelyn V Alexander1, Nicholas Galouzis1, Chelsea Wozniak1
1Department of Surgery, University of Arizona, Tucson, Arizona.
The Journal of surgical research
|May 29, 2025
概括
将高级实践提供者 (APP) 整合到胰腺手术团队中,改善了患者的护理. 这导致了更短的住院时间和更早的并发症检测,增强恢复和减少再入院.
科学领域:
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 胰腺手术具有较高的并发症率 (30-50%) 和再入院率 (30-40%).
- 缺乏早期的术后问题识别和护理连续性有助于不利的结果.
研究的目的:
- 评估先进实践提供者 (APP) 领导的结构化随访协议对胰腺手术结果的影响.
- 评估APP整合与再接收率,停留时间 (LOS),死亡率和救援失败率 (FTR) 的关联.
主要方法:
- 单一机构对290名接受胰腺切除 (2019-2024) 的患者进行了回顾性研究.
- 在APP之前 (2019年1月至2022年9月) 和在APP之后 (2023年1月至2024年2月) 的组的比较.
- APP的目标是在出院72小时内对所有患者进行评估.
主要成果:
- 术后组的住院时间较短 (6.9 vs. 8.6 天) 和早期的第一次术后访问 (4.9 vs. 10.1 天).
- 退院后再入院的时间在后APP组较短 (8.1 vs 11.3天).
- 在APP整合后观察到较低的30天死亡率 (1.0%对4.2%) 和FTR率 (1.6%对5.8%),尽管在统计学上并不显著.
结论:
- 将APP与结构化的随访协议相结合,与胰腺手术后改善的患者结果有关.
- 这种方法有助于更早地识别并发症,并减少医院LOS.
- 这些发现表明,它对患者的康复有积极的影响,并可能降低死亡率和FTR.
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