• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验

服务提供因素对急诊普通外科患者结局的影响。

Impact of service delivery factors on patient outcomes in emergency general surgery.

机构信息

Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland.

Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland.

出版信息

Surgeon. 2021 Jun;19(3):156-161. doi: 10.1016/j.surge.2020.04.005. Epub 2020 May 20.

DOI:10.1016/j.surge.2020.04.005
PMID:32444339
Abstract

BACKGROUND

Emergency general surgery (EGS) is a high-risk process and is associated with poor outcomes and high mortality. This study aimed to evaluate the service delivery factors in a tertiary referral centre which may influence patient outcomes in emergency general surgery.

METHODS

Data on consecutive patients undergoing emergency laparotomy in a tertiary referral centre were prospectively collected from July 2017-July 2018. An extensive review of patient charts and IT systems was performed to extract demographic, clinical and care pathway data. Transfers for surgery from within the institution or within the centralised hospital network were recorded.

RESULTS

The unadjusted 30-day mortality rate in 163 patients undergoing emergency laparotomy was 13%. On multivariate analysis, 30-day mortality was significantly associated with p-POSSUM predicted mortality (p = 0.003), p-POSSUM predicted morbidity (p = 0.01), SORT mortality (p = 0.004), ICU admission (p = 0.02), ASA grade (p < 0.001) and transfer from non-surgical services (p < 0.001). 19.2% of patients were transferred from a referring hospital for emergency laparotomy. There was no association between inter-hospital transfer and 30-day mortality while increased mortality was observed in patients admitted to non-surgical services who required laparotomy (p < 0.001).

CONCLUSION

Inter-hospital transfer for emergency laparotomy was not associated with increased mortality. Increased mortality was observed in patients admitted to non-surgical services who subsequently required emergency laparotomy. Configuration of emergency general surgery services must accommodate safe and effective transfer of patients, both between and within hospitals.

摘要

背景

急诊普通外科(EGS)是一个高风险的过程,与不良预后和高死亡率相关。本研究旨在评估三级转诊中心的服务提供因素,这些因素可能影响急诊普通外科患者的结局。

方法

从 2017 年 7 月至 2018 年 7 月,前瞻性地收集了在三级转诊中心接受急诊剖腹手术的连续患者的数据。对患者的病历和 IT 系统进行了广泛的回顾,以提取人口统计学、临床和护理路径数据。记录了从院内或集中医院网络转来进行手术的患者。

结果

163 例接受急诊剖腹手术的患者,未调整的 30 天死亡率为 13%。多变量分析显示,30 天死亡率与 p-POSSUM 预测死亡率(p=0.003)、p-POSSUM 预测发病率(p=0.01)、SORT 死亡率(p=0.004)、重症监护病房(ICU)入院(p=0.02)、ASA 分级(p<0.001)和非外科服务转科(p<0.001)显著相关。19.2%的患者从转诊医院转来接受急诊剖腹手术。医院间转科与 30 天死亡率之间无关联,而在需要剖腹手术的非外科服务患者中,死亡率增加(p<0.001)。

结论

急诊剖腹手术的医院间转科与死亡率增加无关。在需要紧急剖腹手术的非外科服务患者中,死亡率增加。急诊普通外科服务的配置必须能够安全有效地转院,包括在医院之间和内部。

相似文献

1
Impact of service delivery factors on patient outcomes in emergency general surgery.服务提供因素对急诊普通外科患者结局的影响。
Surgeon. 2021 Jun;19(3):156-161. doi: 10.1016/j.surge.2020.04.005. Epub 2020 May 20.
2
Comparison of major abdominal emergency surgery outcomes across organizational models of emergency surgical care: Analysis of the UK NELA national database.比较不同紧急外科护理组织模式下主要腹部急诊手术结局:英国 NELA 国家数据库分析。
J Trauma Acute Care Surg. 2024 Feb 1;96(2):305-312. doi: 10.1097/TA.0000000000004056. Epub 2023 Jun 29.
3
Efficacy of POSSUM score in predicting the outcome in patients undergoing emergency laparotomy.POSSUM评分在预测急诊剖腹手术患者预后中的效能。
Pol Przegl Chir. 2014 Apr;86(4):159-65. doi: 10.2478/pjs-2014-0029.
4
Transferred Emergency General Surgery Patients Are at Increased Risk of Death: A NSQIP Propensity Score Matched Analysis.转移的急诊普外科患者死亡风险增加:一项 NSQIP 倾向评分匹配分析。
J Am Coll Surg. 2019 Jun;228(6):871-877. doi: 10.1016/j.jamcollsurg.2019.01.014. Epub 2019 Jan 31.
5
Evaluation of the Collaborative Use of an Evidence-Based Care Bundle in Emergency Laparotomy.评价基于循证的护理捆绑在急诊剖腹术中的联合应用。
JAMA Surg. 2019 May 1;154(5):e190145. doi: 10.1001/jamasurg.2019.0145. Epub 2019 May 15.
6
Emergency Abdominal Surgery in the Elderly: Can We Predict Mortality?老年患者的急诊腹部手术:我们能否预测死亡率?
World J Surg. 2017 Feb;41(2):402-409. doi: 10.1007/s00268-016-3751-3.
7
Impact of interhospital transfer on patient outcomes in emergency general surgery.急诊普通外科中转院对患者结局的影响。
Surgery. 2021 Feb;169(2):455-459. doi: 10.1016/j.surg.2020.08.032. Epub 2020 Oct 23.
8
The statistical importance of P-POSSUM scores for predicting mortality after emergency laparotomy in geriatric patients.老年患者急诊剖腹手术后,P-POSSUM 评分预测死亡率的统计学意义。
BMC Med Inform Decis Mak. 2020 May 7;20(1):86. doi: 10.1186/s12911-020-1100-9.
9
Measuring sarcopenia on pre-operative CT in older adults undergoing emergency laparotomy: a comparison of three different calculations.在接受急诊剖腹手术的老年人的术前 CT 上测量肌肉减少症:三种不同计算方法的比较。
Int J Colorectal Dis. 2020 Jun;35(6):1095-1102. doi: 10.1007/s00384-020-03570-6. Epub 2020 Mar 25.
10
Pre-operative psoas major measurement compared to P-POSSUM as a prognostic indicator in over-80s undergoing emergency laparotomy.术前腰大肌测量与P-POSSUM相比,作为80岁以上接受急诊剖腹手术患者的预后指标。
Eur J Trauma Emerg Surg. 2020 Feb;46(1):215-220. doi: 10.1007/s00068-018-1025-5. Epub 2018 Oct 13.

引用本文的文献

1
Emergency laparotomy preoperative risk assessment tool performance: A systematic review.急诊剖腹手术术前风险评估工具的性能:一项系统评价。
Surg Pract Sci. 2024 Oct 31;19:100264. doi: 10.1016/j.sipas.2024.100264. eCollection 2024 Dec.
2
The "weekend effect" does not impact on outcome of trauma laparotomy - Experience from a level 1 trauma centre in New Zealand.“周末效应”不会影响创伤剖腹手术的结果——来自新西兰 1 级创伤中心的经验。
Chin J Traumatol. 2023 Mar;26(2):73-76. doi: 10.1016/j.cjtee.2022.10.004. Epub 2022 Oct 26.