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内镜检查性能和不良事件连续监测的可行性:单中心经验

Feasibility of Continuous Monitoring of Endoscopy Performance and Adverse Events: A Single-Center Experience.

作者信息

Zandanell Stephan, Gensluckner Sophie, Wolkersdoerfer Gernot, Berr Frieder, Dienhart Christiane, Gantschnigg Antonia, Singhartinger Franz, Wagner Andrej

机构信息

Department of Internal Medicine I, University Clinics Salzburg, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria.

Department of Internal Medicine, Rotthalmünster Hospital, 94094 Rotthalmünster, Germany.

出版信息

Cancers (Basel). 2023 Jan 24;15(3):725. doi: 10.3390/cancers15030725.

Abstract

BACKGROUND

We integrated a standardized questionnaire focusing on adverse events and performance measures in gastrointestinal endoscopy as a mandatory component of the electronical medical record.

METHODS

This retrospective study was conducted using prospectively collected data on quality parameters and adverse events (AEPM) for all diagnostic and therapeutic endoscopic procedures at our center between 2018 and 2020.

RESULTS

A total of 7532 consecutive endoscopic procedures were performed in 5035 patients. The proportion of high-risk examinations and high-risk patients was 20% and 23%, respectively. Severe adverse events (AEs, = 21) occurred in 0.3% of procedures and significantly more often in patients with an ASA score > II (0.6%, < 0.01). We observed no long-term morbidity after severe AEs. Mortality was 0.03% ( = 2). Following screening colonoscopy ( = 242), four endoscopists documented AEPM in more than 98% of the examinations. The cecal intubation rate was 97%, and the mean adenoma detection rate 60%. The quality of lavage was documented in 97% (rated as good in 70% and moderate in 24%).

CONCLUSIONS

The risk of adverse events is significantly increased in patients with an ASA score > II, which should be considered when choosing treatment methods and precautionary measures. Continuous recording of AEPM can be effectively integrated into the clinical reporting process, enabling analysis of the data and feedback to be provided to endoscopists.

摘要

背景

我们将一份聚焦于胃肠道内镜检查不良事件和性能指标的标准化问卷作为电子病历的强制组成部分。

方法

本回顾性研究使用了前瞻性收集的关于2018年至2020年期间我们中心所有诊断性和治疗性内镜检查的质量参数和不良事件(AEPM)的数据。

结果

共对5035例患者进行了7532例连续的内镜检查。高风险检查和高风险患者的比例分别为20%和23%。严重不良事件(AEs,n = 21)发生在0.3%的检查中,在ASA评分> II的患者中明显更常见(0.6%,P < 0.01)。我们未观察到严重不良事件后的长期发病率。死亡率为0.03%(n = 2)。在筛查结肠镜检查(n = 242)后,四名内镜医师在超过98%的检查中记录了AEPM。盲肠插管率为97%,平均腺瘤检出率为60%。灌洗质量记录率为97%(70%评为良好,24%评为中等)。

结论

ASA评分> II的患者发生不良事件的风险显著增加,在选择治疗方法和预防措施时应予以考虑。AEPM的持续记录可以有效地整合到临床报告过程中,从而能够对数据进行分析并向内镜医师提供反馈。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e15/9913416/3d76d24fd7a7/cancers-15-00725-g001.jpg

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