Rodriguez Kimberly, Wilkins Gayle G, Newcomb Patricia, Gwirtz Patricia A, Skrine Robin
Texas Health Harris Methodist Hospital.
University of North Texas.
Oncol Nurs Forum. 2017 May 1;44(3):358-365. doi: 10.1188/17.ONF.358-365.
PURPOSE/OBJECTIVES: To identify previously unstudied factors predicting re-excision following breast-conserving surgery (BCS) and to assess the feasibility of obtaining data about breast density for predictive modeling. .
DESIGN: Retrospective secondary data analysis. .
SETTING: Data were obtained from the cancer registry and electronic health records (EHRs) at Texas Health Harris Methodist Hospital, a large, urban, private, nonprofit hospital in North Texas. .
SAMPLE: 244 patients choosing BCS from 2011-2012. .
METHODS: Data were subjected to univariate analyses (chi-square) followed by logistic regression. .
MAIN RESEARCH VARIABLES: The primary dependent variable was re-excision following BCS. Predictors of interest included lifestyle factors, time from diagnosis to surgery, surgical approach, patient age, and breast density, and controlled for covariates, such as assay results. .
Three factors predicted re-excision with 87% accuracy.
CONCLUSIONS: Women younger than 60 years whose surgery included placement of a wire for localization of tissue to be removed and who underwent surgery soon after diagnosis are the least likely to require reoperation after BCS. Data integrity is critical to the success of research using EHRs and registry information. .
Nurses may improve patient outcomes by helping women considering BCS solve problems that may delay surgery. Nurses can contribute to the success of nursing research by thoroughly and accurately recording patient information in EHRs.
目的/目标：确定保乳手术（BCS）后预测再次切除的先前未研究的因素，并评估获取乳房密度数据用于预测建模的可行性。
回顾性二次数据分析。
数据来自德克萨斯健康哈里斯卫理公会医院的癌症登记处和电子健康记录（EHRs），该医院是北德克萨斯的一家大型城市私立非营利性医院。
2011 - 2012年选择保乳手术的244例患者。
数据先进行单因素分析（卡方检验），然后进行逻辑回归分析。
主要因变量是保乳手术后的再次切除。感兴趣的预测因素包括生活方式因素、从诊断到手术的时间、手术方式、患者年龄和乳房密度，并对协变量进行控制，如检测结果。
三个因素对再次切除的预测准确率达87%。
年龄小于60岁、手术中放置了用于定位待切除组织的金属丝且在诊断后不久即接受手术的女性，保乳手术后再次手术的可能性最小。数据完整性对于使用电子健康记录和登记信息进行的研究成功至关重要。
护士可通过帮助考虑保乳手术的女性解决可能延迟手术的问题来改善患者预后。护士可通过在电子健康记录中全面准确地记录患者信息，为护理研究的成功做出贡献。
