颈脊髓完全损伤后的手术时间:2010年至2020年十年间北美创伤中心临床实践模式的演变。

IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY
Ahmad Essa, Husain Shakil, Armaan K Malhotra, Jetan Badhiwala, Eva Y Yuan, Yingshi He, Andrew S Jack, Francois Mathieu, Avery B Nathens, Jefferson R Wilson, Christopher D Witiw
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引用次数: 0

摘要

本研究旨在量化过去十年(2010-2020 年)北美地区美国外科学院认可的创伤中心治疗完全性创伤性颈脊髓损伤 (SCI) 患者的手术时间变化。这项多中心回顾性观察队列研究使用了 2010 年至 2020 年创伤质量改进计划的数据。研究纳入了所有接受手术治疗的完全创伤性颈椎 SCI 患者。主要结果为从到达治疗医院到脊柱手术的时间(小时)。研究采用了描述性统计和多变量泊松回归模型,按每个纳入的创伤中心对误差标准进行聚类,以评估和量化手术干预时间的年度变化。该研究纳入了北美 484 个创伤中心管理的 6855 例完全创伤性颈椎 SCI 患者。共有 4618 名患者(67.3%)在入院后 24 小时内接受了手术治疗。从 2010 年到 2020 年,手术中位时间平均每年缩短 0.6 小时(±0.15)。手术时间多变量调整模型显示,2010 年至 2020 年间,手术时间每年显著缩短 5%(发病率比 = 0.95;95% 置信区间:0.93-0.96)。这项研究对创伤性颈椎 SCI 后手术干预时间的变化进行了基于真实世界的量化,令人信服。在过去十年中,北美各创伤中心的手术时间呈明显的逐年下降趋势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Time to Surgery Following Complete Cervical Spinal Cord Injury: Evolution of Clinical Practice Patterns Over a Decade from 2010 to 2020 Across North American Trauma Centers.

This study aims to quantify the change in time to surgery for treatment of complete traumatic cervical spinal cord injury (SCI) patients in American College of Surgeons accredited trauma centers across North America over the last decade (2010-2020). This multi-center retrospective observational cohort study used data from the Trauma Quality Improvement Program from 2010 to 2020. All surgically treated patients with complete traumatic cervical SCI were included. Primary outcome was time to spine surgery from treating hospital arrival in hours. Both descriptive statistics and a multi-variable Poisson regression model clustering standard of errors by each included trauma center were used to evaluate and quantify the annual change in time to surgical intervention. The study included 6855 complete traumatic cervical SCI patients managed across 484 trauma centers in North America. Median time to spine surgery was 14.6 h. A total of 4618 patients (67.3%) underwent surgical intervention within 24 h from hospital arrival. From 2010 to 2020, median time to surgery decreased by an average 0.6 h (±0.15) per year. A multi-variable adjusted model for time to surgery demonstrated a significant downward annual reduction of 5% in time to surgery between the years 2010 and 2020 (Incidence rate ratio = 0.95; 95% Confidence Interval: 0.93-0.96). This study provides compelling real-world based quantification of the change in time to surgical intervention following traumatic cervical SCI. A significant decreasing annual trend pertaining to surgical timing across trauma centers in North America over the past decade was demonstrated.

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来源期刊
Journal of neurotrauma
Journal of neurotrauma 医学-临床神经学
CiteScore
9.20
自引率
7.10%
发文量
233
审稿时长
3 months
期刊介绍: Journal of Neurotrauma is the flagship, peer-reviewed publication for reporting on the latest advances in both the clinical and laboratory investigation of traumatic brain and spinal cord injury. The Journal focuses on the basic pathobiology of injury to the central nervous system, while considering preclinical and clinical trials targeted at improving both the early management and long-term care and recovery of traumatically injured patients. This is the essential journal publishing cutting-edge basic and translational research in traumatically injured human and animal studies, with emphasis on neurodegenerative disease research linked to CNS trauma.
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