Department of Surgery, Madigan Healthcare System, Tacoma, WA, USA.
Department of Surgery, Madigan Healthcare System, Tacoma, WA, USA
Gastroenterol Rep (Oxf). 2014 Aug;2(3):221-5. doi: 10.1093/gastro/gou043. Epub 2014 Jul 9.
To determine whether day and time of admission influences the practice patterns of the admitting general surgeon and subsequent outcomes for patients diagnosed with small bowel obstruction.
A retrospective database review was carried out, covering patients admitted with the presumed diagnosis of partial small bowel obstruction from 2004-2011.
A total of 404 patients met the inclusion criteria. One hundred and thirty-nine were admitted during the day, 93 at night and 172 on the weekend. Overall 30.2% of the patients were managed operatively with no significant difference between the groups (P = 0.89); however, of patients taken to the operating room, patients admitted during the day received operative intervention over 24 hours earlier than those admitted at a weekend, 0.79 days vs 1.90 days, respectively (P = 0.05). Overall mortality was low at 1.7%, with no difference noted between the groups (P = 0.35). Likewise there was no difference in morbidity rates between the three groups (P = 0.90).
Despite a faster time to operative intervention in those patients admitted during the day, our study revealed that time of admission does not appear to correlate to patient outcome or mortality.
确定入院日期和时间是否会影响接诊普通外科医生的治疗模式，并进而影响诊断为小肠梗阻患者的治疗效果。
对 2004 年至 2011 年间以疑似部分性小肠梗阻入院的患者进行回顾性数据库研究。
共有 404 名患者符合纳入标准。其中 139 名患者在白天入院，93 名在夜间入院，172 名在周末入院。总体而言，30.2%的患者接受了手术治疗，各组之间无显著差异（P=0.89）；然而，在接受手术治疗的患者中，白天入院的患者比周末入院的患者接受手术干预的时间早 24 小时以上，分别为 0.79 天和 1.90 天（P=0.05）。总体死亡率较低，为 1.7%，各组之间无差异（P=0.35）。同样，三组之间的发病率也没有差异（P=0.90）。
尽管白天入院的患者接受手术干预的时间更快，但本研究表明，入院时间似乎与患者的预后或死亡率无关。
