Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2023 Aug 14;21:eAE0241. doi: 10.31744/einstein_journal/2023AE0241. eCollection 2023.
To evaluate outcomes of vascular surgeries and identify strategies to improve public vascular care.
This was a descriptive, qualitative, and cross-sectional survey involving 30 specialists of the Hospital Israelita Albert Einstein via Zoom. The outcomes of vascular procedures performed in the Public Health System extracted through Big Data analysis were discussed, and 53 potential strategies to improve public vascular care to improve public vascular care.
There was a consensus on mandatory reporting of some key complications after complex arterial surgeries, such as stroke after carotid revascularization and amputations after lower limb revascularization. Participants agreed on the recommendation of screening for diabetic feet and infrarenal abdominal aortic aneurysms. The use of Telemedicine as a tool for patient follow-up, auditing of centers for major arterial surgeries, and the concentration of complex arterial surgeries in reference centers were also points of consensus, as well as the need to reduce the values of endovascular materials. Regarding venous surgery, it was suggested that there should be incentives for simultaneous treatment of both limbs in cases of varicose veins of the lower limbs, in addition to the promotion of ultrasound-guided foam sclerotherapy in the public system.
After discussing the data from the Brazilian Public System, proposals were defined for standardizing measures in population health care in the area of vascular surgery. Notification of complications of arterial surgeries is essential in identifying strategies to improve surgical outcomes. Screening of prevalent and/or morbid diseases allows early intervention and prevention of complications. Use of telemedicine in vascular follow-up allows optimizing the use of resources and reducing the burden on health services. Concentrating complex cases in reference hospitals leads to improved surgical outcomes.
评估血管手术的结果并确定改善公共血管护理的策略。
这是一项描述性、定性和横断面调查，涉及通过 Zoom 参与的 30 名爱因斯坦以色列医院专家。通过大数据分析讨论了公共卫生系统中进行的血管手术的结果，并提出了 53 种改善公共血管护理的潜在策略。
与会者一致认为，有必要报告复杂动脉手术后的某些关键并发症，例如颈动脉血运重建后的中风和下肢血运重建后的截肢。与会者还同意推荐筛查糖尿病足和肾下腹部主动脉瘤。使用远程医疗作为患者随访的工具、对主要动脉手术中心进行审核以及将复杂动脉手术集中在参考中心，也是共识的一部分，还需要降低血管内材料的价值。关于静脉手术，建议在下肢静脉曲张的情况下，应激励同时治疗四肢，此外还应在公共系统中推广超声引导下泡沫硬化疗法。
在讨论了巴西公共系统的数据后，确定了在血管外科学领域的人口保健措施标准化的建议。动脉手术并发症的通知对于确定改善手术结果的策略至关重要。筛选常见和/或病态疾病可以进行早期干预和预防并发症。在血管随访中使用远程医疗可以优化资源的利用并减轻卫生服务的负担。将复杂病例集中在参考医院可以提高手术结果。
