脱水的预测者需要腹手术后门诊干预
Mélissa V Wills1, Jack Loesch1, Juan S Barajas-Gamboa2
1Cleveland Clinic Lerner College of Medicine of Case Western Reserve University.
概括
在减肥手术后,门诊补水疗法 (ORT) 是至关重要的. 年龄较小,女性性别,黑人种族,Roux-en-Y胃绕道和当天出院预测ORT的使用,有助于优化护理.
科学领域:
- 腹部外科手术的结果
- 患者水分管理管理
- 医疗保健资源分配 医疗保健资源分配
背景情况:
- 脱水是急诊诊所和腹部外科手术后再入院的常见原因.
- 门诊补水疗法 (ORT) 使用的预测因素尽管越来越多,但仍然不清楚.
研究的目的:
- 识别空腹手术后ORT利用的独立预测因素.
- 检查ORT利用率和当天放电 (SDS) 协议之间的关系.
主要方法:
- 对代谢和腹部外科认证和质量改善计划 (MBSAQIP) 数据库 (2020-2023) 的分析.
- 包括接受初级腹腔镜袖胃切除术或Roux-en-Y胃旁路术 (RYGB) 的成年患者.
- 多变量后勤回归以确定ORT利用的独立预测因素.
主要成果:
- 在692,525名患者中,3.8%需要ORT.
- ORT患者年轻,BMI较高,更有可能是女性.
- 预测ORT的因素包括年轻年龄,女性性别,SDS,黑人种族和RYGB (所有P<.001).
结论:
- 识别ORT预测器有助于有效实施SDS协议.
- ORT是一种具有成本效益的策略,可以加速释放,同时防止再接收.
- 这些发现有助于减肥计划优化对高风险患者的门诊水化服务.
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