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主动脉瓣置换手术时间变异性的回顾性分析及其与医院设施类型的关联。

A Retrospective Analysis of the Variability in Case Duration for Aortic Valve Replacement and Association With Hospital Facility Types.

机构信息

Department of Anesthesiology, University of California, San Diego, CA; Department of Biomedical Informatics, University of California, San Diego, CA.

Department of Anesthesiology, University of California, San Diego, CA.

出版信息

J Cardiothorac Vasc Anesth. 2018 Apr;32(2):675-681. doi: 10.1053/j.jvca.2017.06.039. Epub 2017 Jun 23.

DOI:10.1053/j.jvca.2017.06.039
PMID:29398380
Abstract

OBJECTIVE

Currently, there are no large-scale studies that compare differences in case duration of aortic valve replacements (AVRs). The primary objective of this study was to determine associations of hospital facility type, geographic location, case volume per year, and time of day with duration of valve replacement surgery.

DESIGN

Retrospective.

SETTING

Data from the National Anesthesia Clinical Outcomes Registry.

PARTICIPANTS

National data from university and non-university hospitals.

INTERVENTIONS

No interventions.

MEASUREMENTS AND MAIN RESULTS

All AVRs from the National Anesthesia Clinical Outcomes Registry were identified from 2010 to 2014. Mean case duration for all AVRs was 360.8 ± 95.8 minutes and was presented based on facility type (university hospital, large community hospital, medium-sized community hospital, and other); US geographic region; time of day (cases performed after 5 pm and before 7 am v day shift); and case volume per year. A multivariable linear regression model was built to determine the association of various patient, procedural, and facility characteristics with case duration. University hospitals were associated with increased case duration for AVRs (p < 0.0001).

CONCLUSIONS

With this large national database, the authors demonstrated that academic hospitals, time of day of the surgery, US region, and case volume per year for a facility are related to the case duration of AVRs.

摘要

目的

目前尚无大规模研究比较主动脉瓣置换术(AVR)病例持续时间的差异。本研究的主要目的是确定医院设施类型、地理位置、每年的病例量以及手术时间与瓣膜置换手术持续时间的关系。

设计

回顾性研究。

地点

国家麻醉临床结果登记处的数据。

参与者

来自大学和非大学医院的全国数据。

干预措施

无干预措施。

测量和主要结果

2010 年至 2014 年期间,从国家麻醉临床结果登记处确定了所有 AVR。所有 AVR 的平均病例持续时间为 360.8±95.8 分钟,并根据设施类型(大学医院、大型社区医院、中型社区医院和其他)、美国地理位置、手术时间(下午 5 点以后和上午 7 点以前进行的手术与白天手术)以及每年的病例量进行呈现。建立了多变量线性回归模型,以确定各种患者、手术和设施特征与病例持续时间的关系。大学医院与 AVR 病例持续时间延长相关(p<0.0001)。

结论

通过这项大型全国性数据库研究,作者表明,学术医院、手术时间、美国地区以及设施每年的病例量与 AVR 的病例持续时间有关。

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