学术中心泌尿道成形术患者的住院医师共同管理:标准化术后护理模式的实施

IF 0.4 Q4 MATHEMATICS, APPLIED
Pegah Taheri, A. Tijerina, Sofia Gereta, Safiya-Hana Belbina, E. Osterberg
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引用次数: 0

摘要

目的:评价与一名外科医生共同治疗尿道狭窄疾病(USD)的患者行尿道成形术(UPL)是否会改善预后和价值。材料:2019年8月,在美国的一个教学中心,一名外科医生对所有接受UPL的患者引入了与医院的共同管理模式。住院医生与泌尿外科医生和辅助人员密切合作。住院医生处理术后问题,如疼痛和合并症,并与泌尿科团队进行查房,以制定处置计划和解决跨学科需求。回顾性分析比较了联合管理开始前的42个月(2016年1月- 2019年7月)和开始后的32个月(2019年8月- 2022年3月)。评估的结果是狭窄复发、并发症、住院时间、再入院和急诊室就诊。结果:2016年1月至2022年3月,共有135例患者(71例由外科医生管理,64例由共同管理)接受了尿道成形术。住院医师共同管理对并发症、住院时间、再入院和急诊室就诊没有影响。使用多变量分析计算混杂变量,没有因素与复发独立相关。两组之间没有人口统计学、合并症或美国麻醉医师协会(ASA)评分差异。结论:本研究表明,基于两组患者相似的结果,住院医生对接受尿道成形术患者的护理可能不逊于外科医生的护理。两组的总住院时间和血压读数没有显著差异,并发症发生率和再入院率也相似。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hospitalist Co-Management of Urethroplasty Patients in an Academic Center: Implementation of a Standardized Postoperative Care Model
Objectives: to evaluate whether hospitalist co-management would lead to improved outcomes and value in patients undergoing urethroplasty (UPL) with a single surgeon for urethral stricture disease (USD). Material: A co-management model with hospitalists was introduced in August 2019 for all patients undergoing UPL for USD with a single surgeon in a United States teaching center. The hospitalist worked closely with the urologic surgeon and the support staff. The hospitalist managed post-operative concerns, such as pain and comorbidities, as well as conducted rounds with the urological team for disposition planning and addressing interdisciplinary needs. Retrospective analysis compared a 42-month period before initiation of co-management (Jan 2016–July 2019) with a 32-month period after initiation (Aug 2019–March 2022). Outcomes assessed were recurrence of stricture, complications, length of stay, readmission, and emergency room visits. Results: A total of 135 patients (71 surgeon-managed, 64 co-managed) underwent urethroplasty from January 2016 to March 2022. Hospitalist co-management did not affect complications, length of stay, readmission, and emergency room visits. Accounting for confounding variables using multivariable analysis, no factors were independently associated with recurrence. There were no demographic, comorbidity, or American Society of Anesthesiologists (ASA) score differences between the two groups. Conclusions: This study suggests that hospitalist care for patients undergoing urethroplasty may be non-inferior to surgeon care, based on similar outcomes between the two groups. There were no significant differences in the total length of stay or blood pressure readings, and the complication rates and hospital readmission rates were also similar.
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来源期刊
CiteScore
0.80
自引率
20.00%
发文量
67
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