目的分析当前版本华西肠癌数据库(Database from Colorectal Cancer,DACCA)中结直肠癌手术后的风险与并发症。方法本次数据分析选取的DACCA版本为2020年7月28日更新版,其中术后康复风险数据项目包括手术反应、体温、排气、疼痛和精神,...目的分析当前版本华西肠癌数据库(Database from Colorectal Cancer,DACCA)中结直肠癌手术后的风险与并发症。方法本次数据分析选取的DACCA版本为2020年7月28日更新版,其中术后康复风险数据项目包括手术反应、体温、排气、疼痛和精神,并发症板块数据项目包括术后、近期和远期,对所选的数据项目进行统计学分析。结果本研究符合筛选条件的数据病案(数据行)总量为6422条,其中“手术反应”的有效数据共4185条(65.2%),“体温”的有效数据共3833条(59.7%),“排气”的有效数据共3835条(59.7%),“疼痛”的有效数据共3597条(56.0%),“精神”的有效数据共3551条(55.3%),“术前”、“术后”、“近期”和“远期”的有效数据均为6422条(100%)。“手术反应”中,结构化显示为“一般”的数据行数最多,有1517条(36.2%)。“体温”升高持续时间中结构化显示为“体温>37.5℃”0 d的数据行数最多,有1980条(51.7%)。“排气”中结构化显示为“3 d”的数据行数最多,有1675条(43.7%)。“疼痛”分级中结构化显示为“不明显”的数据行数最多,有2755条(76.6%)。“精神”中结构化显示为“较好”的数据行数最多,有2976条(83.8%)。“术前”中结构化显示为有术前并发症50条(0.8%);“术后”中结构化显示为有术后并发症595条(9.3%),其中以吻合口漏(80条,13.4%)、炎性肠梗阻(62条,10.4%)、肺部感染(57条,9.6%)和吻合口出血(56条,9.4%)较多;“近期”中结构化显示为无近期并发症6169条(96.1%);“远期”中结构化显示为无远期并发症6283条(97.8%)。结论通过DACCA数据库中真实世界数据展示的并发症变化,提示了术后风险关注点会伴随随访时间的延长,必须随之作出调整。对于并发症评估系统,需要建立相应的类型和风险相结合的完整并发症评估体系,才能真正开展有价值的并发症研究。展开更多
Objectives: To analyze the role of nurse staffing in improving patient safety due to reducing surgical complications in member countries of Organization for Economic Co-operation and Development (OECD).Methods: The nu...Objectives: To analyze the role of nurse staffing in improving patient safety due to reducing surgical complications in member countries of Organization for Economic Co-operation and Development (OECD).Methods: The number of practicing nurses' density per 1000 population and five surgical complications indicators including foreign body left in during procedure (FBL),postoperative pulmonary embolism (PPE) and deep vein thrombosis (DVT) after hip and knee replacement,postoperative sepsis after abdominal surgery (PSA) and postoperative wound dehiscence (PWD) were collected in crude rates per 100,000 hospital discharges for age group of 15 years old and over within 30 days after surgery based on surgical admission-related and all admission-related methods.The observations of 21 OECD countries were collected from OECD Health Statistics during 2010-2015 period.The statistical technique of panel data analysis including unit root test,co-integration test and dynamic long-run analysis were used to estimate the possible relationship between our panel series.Results: There were significant relationships from nurse-staffing level to reducing FBL,PPE,DVT,PSA and PWD with long-run magnitudes of-2.91,-1.30,-1.69,-2.81 and-1.12 based on surgical admission method as well as-6.12,-14.57,-7.29,-1.41 and-0.88 based on all admission method,respectively.Conclusions: A higher proportion of nurses is associated with higher patient safety resulting from lower surgical complications and adverse clinical outcomes in OECD countries.Hence,we alert policy makers about the risk of underestimating the impact of nurses on improving patient safety as well as the quality of health care services in OECD countries.展开更多
文摘Objectives: To analyze the role of nurse staffing in improving patient safety due to reducing surgical complications in member countries of Organization for Economic Co-operation and Development (OECD).Methods: The number of practicing nurses' density per 1000 population and five surgical complications indicators including foreign body left in during procedure (FBL),postoperative pulmonary embolism (PPE) and deep vein thrombosis (DVT) after hip and knee replacement,postoperative sepsis after abdominal surgery (PSA) and postoperative wound dehiscence (PWD) were collected in crude rates per 100,000 hospital discharges for age group of 15 years old and over within 30 days after surgery based on surgical admission-related and all admission-related methods.The observations of 21 OECD countries were collected from OECD Health Statistics during 2010-2015 period.The statistical technique of panel data analysis including unit root test,co-integration test and dynamic long-run analysis were used to estimate the possible relationship between our panel series.Results: There were significant relationships from nurse-staffing level to reducing FBL,PPE,DVT,PSA and PWD with long-run magnitudes of-2.91,-1.30,-1.69,-2.81 and-1.12 based on surgical admission method as well as-6.12,-14.57,-7.29,-1.41 and-0.88 based on all admission method,respectively.Conclusions: A higher proportion of nurses is associated with higher patient safety resulting from lower surgical complications and adverse clinical outcomes in OECD countries.Hence,we alert policy makers about the risk of underestimating the impact of nurses on improving patient safety as well as the quality of health care services in OECD countries.
