School of Economics and Management, Xiamen University of Technology, Xiamen 361024, China.
Department of Information Management, Yuan Ze University, Taoyuan 32003, Taiwan.
Int J Environ Res Public Health. 2017 Dec 19;14(12):1601. doi: 10.3390/ijerph14121601.
Numerous studies have investigated the applicable populations for percutaneous cholecystostomy (PC) procedures, but the outcomes of PC in low-income populations (LIPs) have been insufficiently studied. Data for 11,184 patients who underwent PC were collected from the National Health Insurance Research Database of Taiwan during 2003 and 2012. The overall crude rate of single PC for the LIP was 64% higher than that for the general population (GP). After propensity score matching for the LIP and GP at a ratio of 1:5, the outcome analysis of patients who underwent PC showed that in-hospital mortality was significantly higher in the LIP group than in the GP group, but one-year recurrence was lower. The rates of 30-day mortality and in-hospital complications were higher for the LIP patients than for the GP patients, and the rate of routine discharge was lower, but the differences were not significant. In conclusion, LIP patients undergoing PC exhibit poor prognoses relative to GP patients, indicating that a low socioeconomic status has an adverse impact on the outcome of PC. We suggest that surgeons fully consider the patient's financial situation during the operation and further consider the possible poor post-surgical outcomes for LIP patients.
许多研究都探讨了经皮胆囊造口术(PC)的适用人群,但对低收入人群(LIP)中 PC 的结果研究还不够充分。我们从台湾全民健康保险研究数据库中收集了 2003 年至 2012 年间 11184 例接受 PC 的患者的数据。LIP 患者行单次 PC 的总体粗率比普通人群(GP)高 64%。对 LIP 和 GP 进行倾向评分匹配(1:5)后,对接受 PC 的患者进行的结局分析显示,LIP 组的住院死亡率显著高于 GP 组,但一年复发率较低。LIP 患者的 30 天死亡率和住院并发症发生率高于 GP 患者,常规出院率较低,但差异无统计学意义。总之,与 GP 患者相比,接受 PC 的 LIP 患者预后较差,表明社会经济地位较低对 PC 的结局有不良影响。我们建议外科医生在手术过程中充分考虑患者的财务状况,并进一步考虑 LIP 患者术后可能出现的不良结果。