手术前的急诊室使用是否与手术后的医疗保健使用有关?整体关节关节整形术后? 基于社会脆弱性指数的分析分析
John F Burke1, Corinne E Vennitti1, Wendy M Novicoff1
1University of Virginia Medical Center, Department of Orthopaedic Surgery, Charlottesville, Virginia, United States of America.
PloS one
|February 25, 2026
概括
术前急诊室 (ED) 访问强烈预测术后医疗保健的使用增加,包括ED访问,再入院和关节置换后的再手术. 这种风险无论社会脆弱性如何,都会持续存在.
科学领域:
- 整形外科手术 整形外科手术
- 医疗保健利用研究 医疗保健利用研究
- 公共卫生 公共卫生
背景情况:
- 人口老龄化推动了对全关节置换的需求增加.
- 术后医疗保健的利用正在审查中,以改善结果.
- 确定术后利用的预测因素可以减少医疗保健系统的负担.
研究的目的:
- 分析预测术后医疗保健利用率增加的变量.
- 评估手术前急诊室 (ED) 访问对结果的影响.
- 为了确定社会脆弱性是否影响这些关系.
主要方法:
- 对全膝盖/关节整形术患者 (2017-2020) 的回顾性审查.
- 根据邮政编码确定的社会脆弱性指数 (SVI).
- 分析了手术前的ED访问 (90天和12个月).
- 追踪了术后急救诊所的访问,再入院和重新手术.
主要成果:
- 包括1,059名患者;104人进行了术后ED访问.
- 手术前的ED访问 (90天/12个月) 显著预测了术后的ED访问 (p<0.001).
- 手术前的急救诊所访问也预测了再入院的增加 (p=0.008) 和修复手术 (p=0.039).
- 在SVI和结果之间没有发现统计学意义.
结论:
- 手术前的急救诊所访问是术后医疗保健利用的强有力的预测因素.
- 这种预测能力独立于患者的社会经济因素 (SVI).
- 针对高风险患者,先前进行ED访问,可以优化术后护理.
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