在择期肠切除患者中 alvimopan 的真实世界疗效：统计与临床意义分析。

Real world efficacy of alvimopan on elective bowel resection patients: an analysis of statistical versus clinical significance.

机构信息

Pharmacy Practice Residency, Conemaugh Memorial Hospital, Johnstown, PA, USA.

出版信息

Am J Surg. 2012 Mar;203(3):308-11; discussion 311-2. doi: 10.1016/j.amjsurg.2011.09.007. Epub 2011 Dec 16.

DOI:10.1016/j.amjsurg.2011.09.007

PMID:22178482

Abstract

BACKGROUND

Alvimopan has been shown to shorten time to return of bowel function (RBF), thereby decreasing length of stay (LOS). The aim of this study was to assess the clinical significance of this effect on actual practice. METJODS: A retrospective and prospective study of elective bowel resection patients was performed. Surgeons were assigned to alvimopan users (treatment) or nonusers (control). Primary outcome measures included LOS, RBF, and total hospital cost (THC).

RESULTS

Mean RBF was 2.93 ± 1.22 days in the treatment group and 4.22 ± 1.81 days in the control group (P < .001). Mean LOS was 7 ± 2.6 days in the treatment group and 7.2 ± 2.2 days in the control group. Mean THC was $7,584 ± $4,770 in the treatment group and $7,310 ± $5,471 in the control group (P > .81). LOS decreased by 2.5 days compared with the historical controls, independent of alvimopan use.

CONCLUSIONS

Alvimopan improved RBF but not LOS or THC. Reductions in average LOS of 1 day for ≤6 doses and 2 days if patients received >6 doses were needed to decrease THC.

摘要

背景

阿维莫潘已被证明可缩短肠道功能恢复（RBF）的时间，从而减少住院时间（LOS）。本研究旨在评估这一效应在实际实践中的临床意义。

方法

对择期肠切除术患者进行回顾性和前瞻性研究。将外科医生分配为阿维莫潘使用者（治疗组）或非使用者（对照组）。主要结局指标包括 LOS、RBF 和总住院费用（THC）。

结果

治疗组的平均 RBF 为 2.93 ± 1.22 天，对照组为 4.22 ± 1.81 天（P <.001）。治疗组的平均 LOS 为 7 ± 2.6 天，对照组为 7.2 ± 2.2 天。治疗组的平均 THC 为 7584 ± 4770 美元，对照组为 7310 ± 5471 美元（P >.81）。与历史对照相比，LOS 减少了 2.5 天，与阿维莫潘的使用无关。