Centre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute, Department of Health Care & Epidemiology, University of British Columbia, 828 West 10th Avenue, Vancouver, V5Z 1L8, Canada.
Expert Rev Pharmacoecon Outcomes Res. 2008 Feb;8(1):27-32. doi: 10.1586/14737167.8.1.27.
When access to elective surgery is rationed by wait lists, patients requiring coronary artery bypass grafting may have to wait after a decision to operate has been made. The current literature suggests that a long wait for planned surgical revascularization may lead to worsening of symptoms, deterioration in the patient's condition and a less favorable clinical outcome; it may also increase the probability of preoperative death and unplanned emergency admission. Yet there has been little evidence generated by appropriate statistical methodology that bears on the health effects of a delay in undergoing the operation. In this article, we present three potential approaches for summarizing wait-list data. We also discuss the utility of each method for determining the point at which a delay in waiting for coronary artery bypass surgery becomes too long, from the perspectives of hospital managers, surgeons and patients.
当通过候补名单来限制选择性手术的机会时，已经决定进行手术的患者可能需要等待。目前的文献表明，计划进行的手术血运重建等待时间过长可能会导致症状恶化、患者病情恶化和临床结果更差；也可能增加术前死亡和非计划性急诊入院的概率。然而，很少有适当的统计方法生成的证据表明手术延迟对健康的影响。在本文中，我们提出了三种总结候补名单数据的潜在方法。我们还讨论了每种方法在确定等待冠状动脉旁路手术的延迟时间过长的临界点时，从医院管理者、外科医生和患者的角度来看的实用性。
