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轻症急性胰腺炎患者的早期出院 - 范围综述。

Early discharge of patients with mild acute pancreatitis - A scoping review.

机构信息

Clinical Research Center, Rijnstate Hospital, Wagnerlaan 55, 6815 AD, Arnhem, the Netherlands; Department of Health Technology and Services Research, Technical Medical Centre, Faculty of Behavioral, Management and Social Sciences, University of Twente, Hallenweg 5, 7522 NH, Enschede, the Netherlands.

Department of Gastroenterology and Hepatology, Amsterdam UMC Location University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism, De Boelelaan 1117, 1081HV, Amsterdam, the Netherlands; Department of Research & Development, St. Antonius Hospital, Koekoekslaan 1, 3435CM, Nieuwegein, the Netherlands.

出版信息

Pancreatology. 2024 Sep;24(6):847-855. doi: 10.1016/j.pan.2024.08.006. Epub 2024 Aug 10.

Abstract

BACKGROUND

Acute pancreatitis is a common disease that is usually mild and self-limiting. Early discharge of patients with mild acute pancreatitis, with the use of supporting outpatient services including remote monitoring or smartphone applications, might be safe and could reduce the healthcare demand. The objective of this review was to provide a comprehensive overview of existing strategies aimed at facilitating early discharge of patients diagnosed with mild acute pancreatitis and to assess clinical outcomes, feasibility and costs associated with these strategies.

METHODS

PubMed, Cochrane, Embase, and Web of Science were systematically searched, to identify studies that evaluated strategies to reduce the length of hospital stay in patients with mild acute pancreatitis.

RESULTS

Five studies, including 84 to 419 patients each, were identified and described three different early discharge protocols. The early discharge strategies resulted in a median length of hospital stay of a minimum of 6 to a maximum of 23 h in these studies. Early discharge compared to usual care did not result in increased 30-day readmissions. Additionally, no occurrences of complications or mortality were observed in either group. A significant reduction in overall costs was reported ranging from 43.1 % to 85.4 %.

CONCLUSIONS

Early discharge of patients with mild acute pancreatitis seems both feasible and safe. Further studies are warranted, since focus on safe early discharge could significantly reduce inpatient healthcare utilization and associated costs.

摘要

背景

急性胰腺炎是一种常见疾病,通常为轻度且自限性。对于轻度急性胰腺炎患者,采用远程监测或智能手机应用等支持性门诊服务提前出院可能是安全的,并且可以减少医疗保健需求。本综述的目的是全面概述旨在促进轻度急性胰腺炎患者提前出院的现有策略,并评估这些策略的临床结果、可行性和成本。

方法

系统地检索了 PubMed、Cochrane、Embase 和 Web of Science,以确定评估减少轻度急性胰腺炎患者住院时间的策略的研究。

结果

确定并描述了 5 项研究,每项研究均纳入 84 至 419 例患者,这些研究描述了三种不同的提前出院方案。这些研究中,提前出院策略导致住院时间中位数至少减少了 6 小时,最多减少了 23 小时。与常规护理相比,提前出院并未导致 30 天内再入院率增加。此外,两组均未发生并发症或死亡。报告称总费用显著降低,范围为 43.1%至 85.4%。

结论

提前出院似乎既可行又安全。由于关注安全的提前出院可能会显著减少住院医疗保健的使用和相关成本,因此需要进一步研究。

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