根据种族和社会脆弱性,评估患者的治疗结果和在大动脉外科手术中获得护理
Ananya Shah1, Adam M Carroll1, Nicolas Chanes1
1Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado.
Aorta (Stamford, Conn.)
|June 3, 2025
概括
高社会脆弱性 (SVI) 的少数群体患者在大动脉门手术中面临差异,呈现出更高的敏度,需要更复杂的手术. 针对性,种族敏感的护理策略在所有医疗保健层面都至关重要.
科学领域:
- 心血管外科心血管外科
- 健康差异 在健康上的差异
- 公共卫生 公共卫生
背景情况:
- 种族影响大动脉手术的准入和结果,少数族裔患者往往代表性不足,表现更敏.
- 社会脆弱性指数 (SVI) 量化了社会经济和人口因素,提供了一个评估医疗保健获取障碍的工具.
研究的目的:
- 通过结合种族和SVI来分析大动脉门手术中的患者表现和结果.
- 在接受大动脉门手术的患者中,确定与社会脆弱性和种族相关的护理差异和结果.
主要方法:
- 利用一个单一机构的数据库,其中包括837名接受全门置换或全门修复 (2009-2022) 的患者.
- 患者按种族 (非洲裔美国人,亚洲人,白人,西班牙裔,其他) 和SVI (高≥75%与正常<75%) 分层.
- 患者人口统计数据,表现,手术变量和离院后结果在各队伍中进行了比较.
主要成果:
- 与城市人口统计数据相比,非洲裔美国人和西班牙裔患者的代表性较低.
- 高SVI和少数群体患者呈现出更年轻,血压更高,以及更多出现的大动脉剖析.
- 高SVI组经历了更长的手术时间 (绕道,交叉,循环停止),需要更多的总门置换和术后支持,但辅助手术较少.
- 一年内,非裔美国人出院后的急诊室访问人数更多.
结论:
- 代表性不足的群体遇到严重的护理障碍,显而易见的是人口统计,手术敏度和出院后的差异.
- 仅基于种族的分析掩盖了社会脆弱性指数组内的关键差异.
- 医疗保健策略必须针对高SVI人口量身定制,并对种族敏感,以解决大动脉门手术中的不平等问题.
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