练习使得完美:数量对结果的影响
Bellal Joseph1, Francisco Castillo-Diaz, Mohammad Al Ma'ani
1Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ.
Journal of the American College of Surgeons
|January 20, 2026
概括
程序量 (PV),而不是年度创伤量 (ATV),更好地预测创伤中心的患者结果. 高PV与较低的死亡率和并发症率有关,这表明PV集成可以改善创伤护理的区域化.
科学领域:
- 创伤外科 手术 创伤外科
- 改善医疗保健质量 改善医疗保健质量
- 手术结果研究研究.
背景情况:
- 美国外科医生学院 (ACS) 目前仅使用年度创伤量 (ATV) 验证创伤中心 (TC).
- 这项研究调查了程序体积 (PV) 是否为评估TC性能和患者结果提供了优越的指标.
研究的目的:
- 为了比较ACS I级创伤中心的患者结果,按年度创伤量 (ATV) 与程序量 (PV) 分层分层.
- 为了确定PV是否比ATV更好地预测住院死亡率和重大并发症.
主要方法:
- 在2017-2021年期间,使用ACS-TQIP数据库对2,218,425名在ACS I级医疗中心治疗的患者进行了回顾性分析.
- 根据ATV和PV的数据,中心被分为低,中和高体积的三地产. PV包括新兴的腹腔切除术,胸腔切除术,脑膜切除术/脑膜切除术,血管栓塞和血管修复.
- 采用多变量回归分析来评估体积指标与结果之间的独立关联,并对混因素进行调整.
主要成果:
- 与低和中等PV TC相比,高流程体积 (PV) TC的死亡率 (3.7%) 和重大并发症率 (3.1%) 显著降低.
- 相反,高年创伤量 (ATV) 的TC显示出较高的死亡率 (4.5%),中等ATV的TC显示出最高的重大并发症率 (5.3%).
- 较高的PV独立地与减少死亡率和严重并发症的几率有关,在调整混因素后.
结论:
- 与年度创伤量 (ATV) 相比,程序体积 (PV) 是改善创伤中心患者结果的优越预测指标.
- 将PV整合到创伤中心验证标准中可以增强创伤护理的区域化,将资源与受伤特定的患者需求相协调.
相关概念视频
Catalytically Perfect Enzymes
4.9K
The theory of catalytically perfect enzymes was first proposed by W.J. Albery and J. R. Knowles in 1976. These enzymes catalyze biochemical reactions at high-speed. Their catalytic efficiency values range from 108-109 M-1s-1. These enzymes are also called 'diffusion-controlled' as the only rate-limiting step in the catalysis is that of the substrate diffusion into the active site. Examples include triose phosphate isomerase, fumarase, and superoxide dismutase.
Most enzymes...
Most enzymes...
4.9K
Predicting Reaction Outcomes
10.3K
Kinetics describes the rate and path by which a reaction occurs. In contrast, thermodynamics deals with state functions and describes the properties, behavior, and components of a system. It is not concerned with the path taken by the process and cannot address the rate at which a reaction occurs. Although it does provide information about what can happen during a reaction process, it does not describe the detailed steps of what appears on an atomic or a molecular level. On the other hand,...
10.3K
Impact of Groups on Groups
236
Social psychologists analyze how groups influence one another, shaping social structures and interactions through both cooperation and competition. These dynamics manifest in various ways, ranging from economic partnerships to intergroup conflicts that shape societal structures and perceptions.Cooperation and Competition in Intergroup RelationsIntergroup relationships vary across contexts, sometimes fostering cooperation and mutual benefit while at other times leading to conflict and...
236
Outcomes of Glycolysis
106.8K
Nearly all the energy used by cells comes from the bonds that make up complex organic compounds. These organic compounds are broken down into simpler molecules, such as glucose. As a result, cells extract energy from glucose over many chemical reactions—a process called cellular respiration.
Cellular respiration can occur aerobically (with oxygen) or anaerobically (without oxygen). In the presence of oxygen, cellular respiration starts with glycolysis and continues with pyruvate...
Cellular respiration can occur aerobically (with oxygen) or anaerobically (without oxygen). In the presence of oxygen, cellular respiration starts with glycolysis and continues with pyruvate...
106.8K
Impact
483
Impact occurs when two bodies collide, leading to the application of impulsive forces between them. Analyzing impact mechanics involves considering two colliding particles moving along a line known as the line of impact, which passes through their centers and is perpendicular to the contact plane.
When particles with different initial velocities collide, they induce deformation by applying equal and opposite impulses. At the point of maximum deformation, the particles move together with...
When particles with different initial velocities collide, they induce deformation by applying equal and opposite impulses. At the point of maximum deformation, the particles move together with...
483
Guidelines for Writing Outcome
3.7K
When developing expected outcomes for a patient care plan, the nurse should adhere to the following recommendations:
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
3.7K


