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同时释放手腕道与前臂筋切割:我们做得够好了吗?
Katelyn Koschmeder1, Cara H Lai1, Nathaniel B Hinckley2
1Mayo Clinic, Phoenix, AZ, USA.
同时的手腕道释放 (sCTR) 与前臂筋切除术是常见的. 关节切除术后延迟手腕道释放 (CTR) 显著增加了成本,突出了急性隔间综合征患者及时干预的重要性.
科学领域:
- 整形外科手术 整形外科手术
- 创伤外科 手术 创伤外科
- 卫生经济学 卫生经济学
背景情况:
- 前臂的急性隔间综合征 (ACS) 往往需要出现的带切除术.
- 在前臂筋切割术期间同时释放手腕道 (sCTR) 的实践和经济影响尚未得到充分证实.
- 了解延迟手腕道释放 (CTR) 率和成本对于优化患者护理途径至关重要.
研究的目的:
- 确定为ACS.进行前臂筋切除术的患者中sCTR的全国发病率.
- 分析CTR延迟的频率和相关成本,当它们不同时执行时.
- 评估不同CTR计时策略的经济影响.
主要方法:
- 使用PearlDiver Mariner数据库 (2015-2022) 进行患者队列识别.
- 根据CTR时间相对于前臂带切除术分类的患者:同时,在2周内,2周到1年,1到5年,或没有CTR.
- 分析了报销数据,以比较不同CTR计时组的患者数量和总成本.
主要成果:
- 超过50%的接受新兴前臂筋切除术的患者接受了sCTR.
- 在没有sCTR的人中,31%的人需要1年内CTR,35%的人需要5年内.
- 当CTR在1年内进行,但不是与带切除术同时进行时,观察到的总成本最高.
结论:
- 显著比例 (超过三分之一) 的患者在新兴前臂筋切割过程中没有接受sCTR,需要在一年内接受,这导致医疗保健支出大幅增加.
- 在最初的断层切割手术过程中执行sCTR可能会减轻延迟的护理,并降低相关成本.
- 虽然研究结果表明sCTR有好处,但其追溯性质需要临床判断才能做出最终的治疗决定.
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