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急性胰腺炎与周末效应:周末入院是否会影响患者预后?

Acute pancreatitis and the weekend effect: does weekend admission affect patient outcome?

作者信息

Lipiński Michał, Rydzewska Grażyna

机构信息

Department of Gastroenterology, Central Clinical Hospital of The Ministry of Interior and Administration, Warsaw, Poland.

The Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland.

出版信息

Prz Gastroenterol. 2020;15(3):241-246. doi: 10.5114/pg.2020.95039. Epub 2020 Sep 19.

Abstract

INTRODUCTION

When a patient is admitted to a hospital for acute pancreatitis (AP), the day of the week on which the admission occurs may influence the outcome of care. The link between reduced weekend staffing practices and outcomes for patients hospitalised for AP, however, has been inadequately studied.

AIM

To evaluate the relationship between weekend admission and AP outcome.

MATERIAL AND METHODS

One hundred and twenty-six patients were prospectively included, assessed according to the revised Atlanta criteria, and observed until discharge or death. Weekend and weekday admissions were compared in terms of severity, aetiology, length of hospital stay, and in-hospital mortality.

RESULTS

Patients were divided into two groups according to the timing of admission (weekday, = 99, 78.6%; or weekend, = 27, 21.4%). AP was considered severe in 33 (26.2%) patients, moderately severe AP in 37 (29.4%) patients, and mild in 56 (44.4%) patients. No significant differences were found with regard to the distribution of AP severity between the two groups. The impact of weekend admission was not significant for aetiology or for the length of hospital stay (median of 9 vs. 10 days). In-hospital mortality rates were not significantly different for weekday and weekend admissions.

CONCLUSIONS

Patients admitted for hospitalisation during a weekend received the same level and quality of care at the facility under study as AP patients admitted during the week. Additionally, the rate of favourable outcomes for patients admitted during the weekend was found to be similar to the outcomes of patients admitted on a weekday.

摘要

引言

当患者因急性胰腺炎(AP)入院时,入院当天的星期几可能会影响治疗结果。然而,周末人员配备减少的做法与AP住院患者的治疗结果之间的联系尚未得到充分研究。

目的

评估周末入院与AP治疗结果之间的关系。

材料与方法

前瞻性纳入126例患者,根据修订的亚特兰大标准进行评估,并观察至出院或死亡。比较周末和工作日入院患者在严重程度、病因、住院时间和院内死亡率方面的差异。

结果

根据入院时间将患者分为两组(工作日入院,n = 99,占78.6%;周末入院,n = 27,占21.4%)。33例(26.2%)患者的AP被认为是重度,37例(29.4%)患者为中度重度AP,56例(44.4%)患者为轻度AP。两组之间AP严重程度的分布没有显著差异。周末入院对病因或住院时间(中位数分别为9天和10天)的影响不显著。工作日和周末入院的院内死亡率没有显著差异。

结论

在本研究机构中,周末入院的患者接受的护理水平和质量与一周内入院的AP患者相同。此外,发现周末入院患者的良好治疗结果发生率与工作日入院患者的结果相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65d7/7509903/0f1dac6af154/PG-15-40569-g001.jpg

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