作为对老年手术患者的基准衡量指标,释放到急性后护理
Sarah L Remer1,2, Lynn Zhou1, Mark E Cohen1
1Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL.
Journal of the American College of Surgeons
|August 14, 2025
概括
退院后急性护理是对老年人手术护理质量进行比较的可行指标. 这种对医院数据的分析表明,这一结果可以确定质量改善的领域.
科学领域:
- 老年人手术是一门老年手术.
- 改善医疗保健质量 改善医疗保健质量
- 外科手术的结果
背景情况:
- 退院后急性护理 (PAC) 是一个意想不到和昂贵的手术结果.
- 评估PAC作为对老年人手术护理的基准指标至关重要.
研究的目的:
- 为了确定是否释放到PAC可以作为老年人手术护理质量的可靠比较指标.
- 为了识别与PAC出院相关的高风险患者因素.
主要方法:
- 从非国防部 (DoD) 美国医院在美国外科医生学院国家外科质量改进计划 (ACS NSQIP) 中使用的数据从2023年起.
- 包括65岁以上的患者,在首次手术前从家里入院.
- 采用分层随机效应物流回归与经验贝叶斯平滑用于风险调整的基准测试,专注于放电到"其他设施".
主要成果:
- 分析了来自494家医院的数据,其中包括277,160名患者,其中11.2%的患者被送往PAC.
- 发现22.5%的医院获得了"模范"评级,25.5%的医院获得了"需要改进"评级.
- 在ASA IV/IV分类 (OR 2.50) 和接受住院外科手术 (OR 6.20) 的患者中,发现了PAC排泄的更高风险.
结论:
- 释放到PAC是医院管理老年手术患者的有效基准指标.
- 结果在各种患者子组中保持一致,包括具有重大发病率和高风险状态的患者.
- 基准测量PAC排放可以指导医院针对质量改进举措.
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