医院体积分层使用瘤切除术的分层特异概率比率.
Kristen N Kaiser1, Alexa J Hughes1, Brian M Ruedinger1
1Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery, Indiana University School of Medicine, Indianapolis, IN.
概括
层特异性概率 (SSLR) 显示,更高的胰腺切除体积与更好的患者结果有关,即使在最近的数据中也是如此. 这表明,与之前的一些发现相反,体积与结果的关系仍然存在.
科学领域:
- 手术瘤学手术瘤学
- 医疗保健服务研究 医疗服务研究
- 生物统计学 生物统计学
背景情况:
- 最近的文献质疑胰腺切除术中由于感知衰减而产生的体积-结果关系.
- 这种感知减弱可能源于单个,二进制体积切断的方法限制.
- 层特异性概率比率 (SSLR) 提供了一种方法来定义经验体积层,并检测持久梯度.
研究的目的:
- 用SSLR来定义胰腺切除术的体积层.
- 通过多个结果来评估这些层的稳定性.
- 检查现代手术队伍中体积-结果关联的持久性.
主要方法:
- 利用国家癌症数据库确定接受胰腺切除术 (2004-2021) 的患者.
- 使用SSLR基于90天术后死亡率的定义体积层.
- 通过分层结果分析 (基平方) 评估时间值稳定性.
主要成果:
- 分析了982个机构的61,920例胰腺切除术;90天死亡率为5.4%.
- SSLR确定了六个体积层 (每年≤3至≥121次手术),死亡率下降 (11%至2.3%;p<0.001).
- 确定了21个手术/年的最佳门;体积-结果关联在时间层中持续存在 (p<0.001).
结论:
- SSLR表明胰腺切除术的持续体积-结果关联,即使有当代数据.
- 这些发现表明,以前关于减弱关系的报道可能是由于静态,二进制切线的限制.
- 在复杂的外科手术过程中,经验性推导的体积层对于准确评估体积与结果关系至关重要.
相关概念视频
Hospitals-II
1.2K
Hospitals provide inpatient and outpatient services. Inpatient services provide care to patients that stay in the hospital for an extended period, ranging from days to months. Examples of inpatient services include intensive care units, hospital wards, or surgeries. Outpatient services provide care to patients who come to a hospital for a diagnostic or treatment but do not stay overnight —for example, diagnostic tests, surgical procedures, or health education.
Nurses that work in...
Nurses that work in...
1.2K
Hospitals-I
1.6K
Hospitals offer medical and surgical care to the sick and injured, along with accommodation while they recover. At the same time, they also provide outpatient, emergency, psychiatric, and rehabilitation services to meet various community needs. In addition to providing medical care, hospitals also act as hubs for medical research and training. Hospitals use clinical procedures and evidence-based practice standards to deliver patient care. To deliver safe and efficient care, a nurse must stay up...
1.6K
Poisson's Ratio
1.1K
Poisson's ratio is a material property that indicates their stress response. It explains the connection between the elongation or compression a material undergoes in the direction of an applied force and the contraction or expansion it experiences perpendicular to that force. When a slender bar is loaded axially, it stretches in the direction of the force and contracts laterally. Poisson's ratio is the negative ratio of this lateral contraction to the axial elongation. The negative sign...
1.1K
Odds Ratio
1.9K
The odds ratio (OR) is a statistical measure used extensively in epidemiology and research to quantify the strength of association between exposure and outcome across different groups. Unlike relative risk, which compares the probabilities of an event occurring, the odds ratio compares the odds of an event occurring in the exposed group to the odds of it occurring in the unexposed group. The odds, in this context, are calculated as the probability of the event happening divided by the...
1.9K
Hazard Ratio
606
The hazard ratio (HR) is a widely used measure in clinical trials to compare the risk of events, such as death or disease recurrence, between two groups over time. It reflects the ratio of hazard rates—the instantaneous risk of the event occurring—between a treatment group and a control group. This measure provides valuable insights into the relative effectiveness of a treatment by assessing how the risk of an event differs between the two groups.
For example, in a clinical trial...
For example, in a clinical trial...
606
The Ratio of X Chromosome to Autosomes
9.6K
In most organisms, sex is determined by the ratio of X and Y chromosomes. However, in some organisms, such as Drosophila and C.elegans, sex is determined by the ratio of the number of X chromosomes to the number of sets of autosomes. The Y chromosome in Drosophila is active but does not determine sex. It contains genes responsible for the production of sperms in adult flies.
Normal male Drosophila has a ratio of one X chromosome to two sets of autosomes. In contrast, normal female...
Normal male Drosophila has a ratio of one X chromosome to two sets of autosomes. In contrast, normal female...
9.6K


