建立成人脑肿瘤患者的标准绩效衡量指标：一项全国住院患者样本数据库研究。
Establishing standard performance measures for adult brain tumor patients: a Nationwide Inpatient Sample database study.
机构信息
Corresponding Author: Maryam Rahman, MD, MS, Department of Neurosurgery, University of Florida, PO Box 100265, Gainesville, FL 32610.
出版信息
Neuro Oncol. 2013 Nov;15(11):1580-8. doi: 10.1093/neuonc/not108. Epub 2013 Sep 30.
BACKGROUND
The Agency for Healthcare Research and Quality (AHRQ) patient safety indicators (PSIs) and the Centers for Medicare and Medicaid Services (CMS) hospital acquired conditions (HACs) are used to evaluate the safety and quality of health care. We determined the incidence rates of PSIs and HACs among brain tumor patients in the Nationwide Inpatient Sample database (NIS).
METHODS
We queried the NIS for all hospitalizations involving a brain tumor. We determined the incidence rates of various PSIs and HACs among these patients by searching the hospital records for codes in the International Classification of Diseases, 9th Revision indicating each PSI or HAC.
RESULTS
Among the 501 908 hospitalizations involving a brain tumor in the NIS, there were 102 046 occurrences of an AHRQ PSI, with 16% of patients experiencing one or more AHRQ PSI. Among brain tumor patients treated without surgery, 17.2% experienced ≥ 1 PSI. Among brain tumor patients treated with surgery, 9.8% experienced ≥ 1 PSI. The most common PSIs were postoperative respiratory failure, deep vein thrombosis, and sepsis. The total number of HACs associated with brain tumor patients was 13 778, with 2.63% of patients experiencing ≥1 HAC. Among brain tumor patients treated without surgery, 3.0% experienced ≥ 1 HAC. Among brain tumor patients treated with surgery, 7.4% experienced ≥ 1 HAC. The most common HACs were falls and trauma and pressure ulcers. Increasing comorbidity score was associated with increased likelihood of almost all PSIs and HACs.
CONCLUSION
These data may be used to determine individual institutional improvements or success by comparison.
背景
医疗保健研究与质量署（AHRQ）的患者安全指标（PSIs）和医疗保险和医疗补助服务中心（CMS）的医院获得性条件（HACs）用于评估医疗保健的安全性和质量。我们在全国住院患者样本数据库（NIS）中确定了脑肿瘤患者的 PSIs 和 HAC 发生率。
方法
我们在 NIS 中查询了所有涉及脑肿瘤的住院治疗。我们通过在医院记录中搜索表示每个 PSI 或 HAC 的国际疾病分类第 9 版代码，确定了这些患者中各种 PSIs 和 HAC 的发生率。
结果
在 NIS 中涉及脑肿瘤的 501 908 次住院治疗中，有 102 046 例发生了 AHRQ PSI，其中 16%的患者经历了一次或多次 AHRQ PSI。在未经手术治疗的脑肿瘤患者中，17.2%经历了≥1 次 PSI。在接受手术治疗的脑肿瘤患者中，9.8%经历了≥1 次 PSI。最常见的 PSIs 是术后呼吸衰竭、深静脉血栓形成和败血症。与脑肿瘤患者相关的 HAC 总数为 13 778 例，其中 2.63%的患者经历了≥1 例 HAC。在未经手术治疗的脑肿瘤患者中，3.0%经历了≥1 例 HAC。在接受手术治疗的脑肿瘤患者中，7.4%经历了≥1 例 HAC。最常见的 HACs 是跌倒和创伤以及压疮。合并症评分的增加与几乎所有 PSIs 和 HACs 的发生可能性增加有关。
结论
这些数据可用于通过比较确定个别机构的改进或成功。
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