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急性护理手术模式对韩国急性阑尾炎管理的影响:一项回顾性队列研究。

Impact of an Acute Care Surgery Model on the Management of Acute Appendicitis in South Korea: A Retrospective Cohort Study.

作者信息

Yi Gun-Hee, Lee Hak-Jae, Lee Seul, Yoon Jong-Hee, Hong Suk-Kyung

机构信息

Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.

Division of Acute Care Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.

出版信息

Emerg Med Int. 2021 Mar 26;2021:5522523. doi: 10.1155/2021/5522523. eCollection 2021.

Abstract

BACKGROUND

The acute care surgery (ACS) system is a new model for the prompt management of diseases that require rapid treatment in patients with acute abdomen. This study compared the outcomes and characteristics of the ACS system and traditional on-call system (TROS) for acute appendicitis in South Korea.

METHODS

This single-center, retrospective study included all patients (aged ≥18 years) who underwent surgery for acute appendicitis in 2016 and 2018. The TROS and ACS system were used for the 2016 and 2018 groups, respectively. We retrospectively obtained data on each patient from the electrical medical records. The independent samples -test and Mann-Whitney -test were used for continuous and nonnormally distributed data, respectively.

RESULTS

In total, 126 patients were included. The time taken to get from the emergency room admission to the operating room, operation times, and postoperative complication rates were similar between both groups. However, the length of the hospital stay was shorter in the ACS group than in the TROS group (4.3 ± 3.2 days vs. 7.2 ± 9.6 days, =0.039).

CONCLUSIONS

Since the introduction of the ACS system, the length of hospital stay for surgical patients has decreased. This may be due to the application of an integrated medical procedure, such as a new clinical pathway, rather than differences in the surgical techniques.

摘要

背景

急性护理手术(ACS)系统是一种用于迅速处理急腹症患者中需要快速治疗疾病的新模式。本研究比较了韩国急性阑尾炎患者中ACS系统和传统随叫随到系统(TROS)的治疗结果及特点。

方法

这项单中心回顾性研究纳入了2016年和2018年所有接受急性阑尾炎手术的患者(年龄≥18岁)。2016年组和2018年组分别采用TROS和ACS系统。我们从电子病历中回顾性获取每位患者的数据。独立样本t检验和曼-惠特尼U检验分别用于连续数据和非正态分布数据。

结果

总共纳入126例患者。两组患者从急诊入院到手术室的时间、手术时间和术后并发症发生率相似。然而,ACS组的住院时间比TROS组短(4.3±3.2天对7.2±9.6天,P=0.039)。

结论

自引入ACS系统以来,外科手术患者的住院时间缩短。这可能是由于应用了综合医疗程序,如新的临床路径,而非手术技术的差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11ac/8018862/9813ed4e9849/EMI2021-5522523.001.jpg

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