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儿童心脏外科手术中中心体积和救援失败:有没有关系?

Dhaval Chauhan¹, J Hunter Mehaffey¹, J W Awori Hayanga¹

¹Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia.

The Annals of thoracic surgery

|September 15, 2025

概括

医院病例数量不会影响小儿心脏外科手术中救援率的失败. 高容量和低容量医院都显示了类似的结果,这表明容量不是一个可靠的质量指标.

科学领域:

儿科心脏手术儿科心脏手术
质量指标质量指标
医疗保健研究成果研究成果

背景情况:

救援失败 (FTR) 是儿科心脏外科手术的一个关键质量指标.
评估医院体积和FTR之间的联系对于结果评估至关重要.

研究的目的:

调查儿童心脏手术后每年住院病例数量与救援失败 (FTR) 之间的关系.
确定医院体积是否可靠地预测这个手术群体中患者的治疗结果.

主要方法:

使用了儿童住院患者数据库 (2016年,2019年) 针对心肺旁路术 (CPB) 病例.
定义FTR为在至少一个术后并发症后的住院患者死亡率.
根据每年的CPB病例量三分之一,将医院分为低,中和高数量.
采用混合效应多变量物流模型来分析病例数量与FTR之间的关联.

主要成果:

在228家医院分析了10528名患有术后并发症的患者.
在低,中和高体积医院之间没有发现FTR率的统计学上显著差异.
在所有体积类别中确定了表现不佳和表现过高的医院.

结论:

医院体积与小儿心脏手术后的救援失败 (FTR) 没有关联.
在所有数量组中存在表现不佳和表现过高的人,表明独立于病例数量的变化.
医院体积可能不是一个可靠的指标来比较儿童心脏手术的质量和结果.

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