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对接受乳房切除手术的脆弱患者的护理位置分类的效率

Claire R Morton^1,2, Yu-Jen Chen³, Kenneth Williams³

¹Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA. cmorton3@bwh.harvard.edu.

Annals of surgical oncology

|January 14, 2026

概括

门诊外科中心 (ASC) 可以安全地对脆弱的老年人进行乳房切除术,从而节省潜在的成本. 虽然转移率略高,但经济效益表明ASC是这个人群的可行选择.

科学领域:

老年人手术是一门老年手术.
医疗保健服务研究医疗服务研究
手术瘤学手术瘤学

背景情况:

乳腺切除手术在门诊外科中心 (ASC) 和住院医院进行,选择地点的准则尚不清楚.
老年人,尤其是那些脆弱的人,面临着更高的术后风险.
转移到急性医院后ASC护理表明出院设置的潜在不合适.

研究的目的:

分析脆弱与乳房切除护理地点的关联 (ASC与住院患者).
评估脆弱患者从ASC转移到医院的风险.
为了模拟 ambulatory 乳房切除术对不同脆弱程度的成本影响.

主要方法:

使用后勤回归建模来评估脆弱对护理场所和转移的影响.
对于健壮的乳腺切除手术,进行了成本分析,而不是先前/脆弱的患者.

主要成果:

虚弱/预虚弱显著增加了住院护理 (OR 5.856) 和转移 (OR 2.640) 的几率,尽管转移率仍然很低 (<0.4%).
对于所有脆弱前期和脆弱患者的门诊性乳房切除术可以节省大量的成本 (每名患者8404美元).
目前的转移率是超过100倍低于抵消 ambulatory 成本节省所需的门.

结论:

脆弱和脆弱前的老年人可以考虑在ASC进行乳房切除.
经济效益支持这些患者使用ASC,尽管转移风险略高.
进一步研究优化ASC对弱势老年人群的护理是有必要的.

关键词:

健行外科手术健行外科手术脆弱性脆弱性脆弱性进行乳腺切除术.护理场所的所在地

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