2001 至 2005 年英国国民保健信托中，医院机构容量对大型急诊结直肠手术后术后死亡率的影响。
Impact of hospital institutional volume on postoperative mortality after major emergency colorectal surgery in English National Health Service Trusts, 2001 to 2005.
机构信息
Department of Biosurgery and Surgical Technology, St. Mary's Hospital, London,
出版信息
Dis Colon Rectum. 2010 Apr;53(4):393-401. doi: 10.1007/DCR.0b013e3181cc6fd2.
PURPOSE
The aim of this study was to investigate the effects of institutional volume on postoperative mortality in patients undergoing emergency major colorectal surgical procedures in England between 2001 and 2005.
METHODS
All of the emergency excisional colorectal procedures performed between the above dates were included from the Hospital Episode Statistics data set. Institutions were divided into high-, medium-, and low-volume tertiles according to the total major emergency colorectal caseload.
RESULTS
During the study period, 37,094 emergency excisional colorectal procedures were performed in 166 English National Health Service institutions. Overall 30-day postoperative mortality was 15.49%, increasing to 29.18% at 1 year after surgery. Overall 30- and 365-day mortality rates were similar among institutional volume tertiles (P > .05) after adjustment for age, sex, social deprivation, diagnosis, procedure type, and comorbidity score.
CONCLUSION
Hospital Episode Statistics data suggest that institutions with high volumes of emergency colorectal caseload do not demonstrate lower mortality after emergency major excisional colorectal surgery.
目的
本研究旨在调查 2001 年至 2005 年期间英国接受紧急大结肠直肠外科手术的患者的机构容量对术后死亡率的影响。
方法
从医院入院统计数据集中纳入了上述日期之间进行的所有紧急切除结肠直肠手术。根据主要紧急结肠直肠总病例数，将机构分为高、中、低容量三分位数。
结果
在研究期间，166 家英国国民保健服务机构进行了 37094 例紧急切除结肠直肠手术。总体 30 天术后死亡率为 15.49%，手术后 1 年增加到 29.18%。调整年龄、性别、社会剥夺、诊断、手术类型和合并症评分后，机构容量三分位数之间的总体 30 天和 365 天死亡率相似（P＞.05）。
结论
医院入院统计数据表明，紧急大切除结肠直肠手术后，高容量紧急结肠直肠病例量的机构死亡率并未降低。
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