外科医生年龄与患者血液动力学不稳定性之间的关联在体红细胞瘤手术中:一个多中心队列研究
Sarah Chambers Skinner1,2, Léa Pascal1,2, Stéphanie Polazzi1,2
1Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1.
Journal of patient safety
|July 1, 2025
概括
外科医生的年龄会影响手术内血动力学不稳定性 (IHI) 在染细胞瘤手术期间,表现在48岁左右达到顶峰. 在整个职业生涯中保持外科医生的技能对于患者安全至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 麻醉学 麻醉学
背景情况:
- 乳红细胞瘤切除是一种罕见而复杂的手术,需要高水平的外科医生专业知识.
- 在此过程中,手术内血动力学不稳定性 (IHI) 是一个重要的风险.
- 外科医生的技术和非技术技能对于减轻IHI至关重要.
研究的目的:
- 调查外科医生年龄与手术内血动力学不稳定 (IHI) 的发生之间的关系,在接受染细胞瘤手术的患者中.
- 为了确定外科医生的表现在IHI发生方面可能是最佳的年龄.
主要方法:
- 一项回顾性队列研究分析了由44名年龄在30-65岁之间的外科医生进行的990次染细胞瘤手术的数据.
- 外科医生的年龄被用作经验的代理,IHI发生是主要结果.
- 调整了患者和手术混因子的GEE逻辑回归模型,用于评估外科医生年龄和IHI之间的关联.
主要成果:
- 在外科医生年龄和IHI之间观察到一个形关系,标准化的IHI率从30岁的71.7%下降到48岁的最低50.4%,然后增加到65岁的70.2%.
- 对于低体积外科医生来说,IHI在55-65岁的患者中比45-55岁的患者更有可能发生 (aOR=1.71).
- 对于高体积的外科医生来说,IHI在30-44岁的人群中比45-55岁更有可能发生 (aOR=2.05).
结论:
- 外科医生在染细胞瘤手术中的表现似乎在职业生涯中期 (大约48岁) 达到顶峰,之后可能会下降.
- 支持在所有职业生涯阶段的外科医生持续表现的策略是有必要的.
- 建议进一步研究复杂外科手术中的与年龄相关的性能趋势.
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