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实习生操作自主性与乳腺外科手术中术后并发症之间的关联

Sarah W Yuen1, Nicole Finney2, Shaina Sedighim1

  • 1Division of Surgical Oncology, Department of Surgery, University of California, Irvine, Orange, California.

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概括

乳腺手术中的住院自主性与更少的并发症和死亡率没有增加有关. 这项研究发现,尽管风险较高的病例,但培训人员参与程序的增加并没有对患者的结果产生负面影响.

关键词:
自主权 自主权是什么?乳房外科手术 乳房手术居民居民的情况.进行外科手术教育.实习生 实习生 实习生

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科学领域:

  • 外科教育的外科教育
  • 患者安全 患者安全
  • 乳腺外科手术的结果

背景情况:

  • 外科住院医生的操作独立性下降影响了培训和未来的实践准备.
  • 在乳腺外科手术中,评估实习生自主性与患者结果之间的联系至关重要.

研究的目的:

  • 评估在乳腺外科手术中住院手术自主性和术后并发症之间的关联.
  • 为了确定培训人员参与度的增加是否与患者不良事件或死亡率相关.

主要方法:

  • 利用了2005-2012年美国外科医生学院国家外科质量改进计划 (ACS NSQIP) 数据库.
  • 乳腺手术病例分层分为主治医院 (AP),住院监督医院 (RS) 和住院主治医院 (RP) 的参与.
  • 使用回归分析分析了伤口并发症,停留时间,重大并发症和30天死亡率.

主要成果:

  • 住院初级 (RP) 病例涉及较年长的患者,具有较高的ASA类和更多的支淋巴切除术.
  • 经营时间随着居民的自主性而增加,但逗留时间减少.
  • 居民初级病例显示伤口并发症率最低;在各组之间没有观察到重大并发症或死亡率的显著差异.

结论:

  • 在乳腺外科手术中,学员的手术自主性与低的并发症和死亡率有关.
  • 尽管管理高风险患者和手术,但居民自主性并没有增加发病率或死亡率.
  • 需要进一步的研究来澄清实习生自主权对瘤结果的影响.