Hahn Peter F, Guimaraes Alexander R, Arellano Ronald S, Mueller Peter R, Gervais Debra A
Department of Radiology, Massachusetts General Hospital and Harvard Medical School, White 220, 55 Fruit Street, Boston, MA, 02114.
Department of Radiology, Massachusetts General Hospital and Harvard Medical School, White 220, 55 Fruit Street, Boston, MA, 02114.
Acad Radiol. 2015 Jul;22(7):904-8. doi: 10.1016/j.acra.2015.01.002. Epub 2015 Feb 20.
To determine trends in nonvascular image-guided procedures at an urban general hospital over a 10-year period and to compare utilization of nonvascular interventional radiology (IR) over the decade 2001-2010 to a previously reported analysis for 1991-2000.
With institutional review board approval, a 20-year quality assurance database verified against the radiology information system was queried for procedure location (eg, pleura, liver, bowel, and abdomen) and type (eg, biopsy, catheter insertion, and transient drainage), demographics, and change over time. Yearly admissions and new hospital numbers assigned each year served to normalize for overall hospital activity.
A total of 50,195 IR procedures were performed in 24,309 distinct patients (male:female, 12,625:11,684; average age, 60 years), 940 procedures performed in age <20 years, and 571 procedures performed in patients aged ≥90 years. A total of 15345, 4377, and 1754 patients had one, two, or three procedures, respectively; 470 had ≥10 procedures. Twenty-seven supervising radiologists and 277 individuals participated as operators, double the previous decade. Biopsy (4.8% average yearly increase), abdominal drainage (7.3%), paracentesis (12.9%), tube manipulation (13.0%), suprapubic bladder tube insertion (21.0%), and gastrostomy (44.6%) all increased strongly (P < .001) over 120 months but not biliary drainage, nephrostomy, or chest tubes. Procedures increased faster than either admissions or new hospital numbers (P < .001). For each 1000 new hospital numbers, IR service performed 48 procedures versus 31 the previous decade (P < .0005).
Referrals for nonvascular IR procedures have doubled over 2 decades, outpacing growth in new hospital patients and requiring increased resource allocation.
确定一家城市综合医院在10年期间非血管影像引导手术的趋势，并将2001 - 2010年这十年间非血管介入放射学（IR）的使用情况与先前报道的1991 - 2000年的分析结果进行比较。
经机构审查委员会批准，查询了一个20年的质量保证数据库（该数据库已与放射学信息系统核对），以获取手术部位（如胸膜、肝脏、肠道和腹部）、类型（如活检、导管插入和临时引流）、人口统计学数据以及随时间的变化情况。每年的入院人数和每年分配的新住院患者数量用于对医院的总体活动进行归一化处理。
在24309名不同患者中总共进行了50195例IR手术（男：女，12625：11684；平均年龄60岁），940例手术在年龄小于20岁的患者中进行，571例手术在年龄≥90岁的患者中进行。分别有15345、4377和1754名患者接受了一次、两次或三次手术；470名患者接受了≥10次手术。27名放射科监督医生和277名人员作为操作人员参与，是前十年的两倍。活检（平均每年增长4.8%）、腹腔引流（7.3%）、腹腔穿刺（12.9%）、管道操作（13.0%）、耻骨上膀胱造瘘管插入（21.0%）和胃造瘘术（44.6%）在120个月内均显著增加（P < .001），但胆道引流、肾造瘘术或胸管置入术未增加。手术增加的速度比入院人数或新住院患者数量都要快（P < .001）。每1000名新住院患者，IR服务进行48例手术，而前十年为31例（P < .0005）。
非血管IR手术的转诊量在20年里增加了一倍，超过了新住院患者的增长速度，需要增加资源配置。
