缩短肿瘤外科病人的住院时间:早期住院医师共同管理的影响

R. T. Costa
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引用次数: 1

摘要

2013年1月至2016年12月,我们在巴西一家480张床位的癌症中心的医院内科协助下,对癌症患者进行了一项观察性回顾性研究。数据从前瞻性收集的数据库中检索。在研究期间,我们共纳入了4695名由医院科评估的患者。包括以下临床数据:患者人数、年龄、平均住院时间(ALOS)和从入院到由一名医院医生开始共同治疗的时间。采用线性回归对研究期间的ALOS进行比较。根据手术患者入院至住院医师团队第一次评价的时间分为两组:早期管理组(至第一次评价时间≤3天)和晚期管理组(至第一次评价时间≤30天)。年龄用均数±标准差表示,组间平均年龄比较采用t-student检验。非参数变量描述为中位数(25-75%百分位数)。我们使用Mann-Whitney检验来分析非参数变量。以手术人群的中位住院生存时间(16天)作为截断值,以生存时间大于16天(高生存时间)为终点,构建Kaplan-Meier曲线。主要结局是评估患者的住院时间(LOS)。假定值<。0.05认为有统计学意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reducing the Length of Stay in Oncological Surgical Patients: Impact of Early Hospitalist Co-Management
We conducted an observational retrospective study in cancer patients assisted by the Hospital Medicine Department in a 480 beds Cancer Center in Brazil between January 2013 and December 2016. Data were retrieved from a prospectively collected database. We included a total of 4695 patients that were evaluated by the Hospitalist Department in the study period. The following clinical data were included: number of patients, age, Average Length of Stay (ALOS) and time from hospital admission to the beginning of co-management by a hospitalist. Linear regression was used to compare the ALOS during the study period. The surgical patients were divided in two groups according to the time from hospital admission to the first evaluation of the hospitalist team: early comanagement group (time to first evaluation ≤ 3 days) vs late comanagement group (time to first evaluation > 3 days). Age was described as mean ± standard deviation and mean age between groups were compared using the t-student test. Non-parametric variables were described as median (25-75% percentile). We used the Mann-Whitney test to analyze the non-parametric variables. The median hospital LOS (16 days) for the surgical population was used as the cutoff value to build a Kaplan-Meier curve considering a LOS higher than 16 days (high LOS) as endpoint. The primary outcome was the hospital length of stay (LOS) of the patients evaluated. P-values <.05 were considered to indicate statistical significance.
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