日本医院手术死亡率和抢救失败率低的要求

IF 2.9 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Annals of Gastroenterological Surgery Pub Date : 2023-10-16 DOI:10.1002/ags3.12745
Itaru Endo, Arata Takahashi, Hisateru Tachimori, Hiroaki Miyata, Yuki Homma, Takafumi Kumamoto, Ryusei Matsuyama, Yoshihiro Kakeji, Yuko Kitagawa, Yasuyuki Seto
{"title":"日本医院手术死亡率和抢救失败率低的要求","authors":"Itaru Endo,&nbsp;Arata Takahashi,&nbsp;Hisateru Tachimori,&nbsp;Hiroaki Miyata,&nbsp;Yuki Homma,&nbsp;Takafumi Kumamoto,&nbsp;Ryusei Matsuyama,&nbsp;Yoshihiro Kakeji,&nbsp;Yuko Kitagawa,&nbsp;Yasuyuki Seto","doi":"10.1002/ags3.12745","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>We explored institutional factors in Japan associated with lower operative mortality and failure-to-rescue (FTR) rates for eight major gastrointestinal procedures.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A 22-item online questionnaire was sent to 2119 institutional departments (IDs) to examine the association between institutional factors and operative mortality and FTR rates. IDs were classified according to the number of annual surgeries, board certification status, and locality. In addition, the top 20% and bottom 20% of IDs were identified based on FTR rates and matched with the results of the questionnaire survey. Factors associated with operative mortality were selected by multivariate analysis.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of the 1083 IDs that responded to the questionnaire, 568 (213 382 patients) were included in the analysis. Operative morbidity, operative mortality, and FTR rates in the top 20% and bottom 20% of IDs were 13.1% and 8.4% (<i>p</i> &lt; 0.001), 0.52% and 4.3% (<i>p</i> &lt; 0.001), and 4.0% and 51.2% (<i>p</i> &lt; 0.001), respectively. Based on the patients' background characteristics, the top 20% of IDs handled more advanced cases. No significant difference in locality was seen between better or worse hospital FTR rates, but fewer esophagectomies, hepatectomies, and pancreatoduodenectomies were performed in depopulated areas. Six items were found to be associated with operative mortality by multivariate logistic analysis. Only 50 (8.8%) IDs met all five factors related to better FTR rates.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The present findings indicate that several hospital factors surrounding surgical treatment, characterized by abundant human resources, are closely related to better postoperative recovery from severe complications.</p>\n </section>\n </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12745","citationCount":"0","resultStr":"{\"title\":\"Requirements for hospitals in Japan to have low operative mortality and failure-to-rescue rates\",\"authors\":\"Itaru Endo,&nbsp;Arata Takahashi,&nbsp;Hisateru Tachimori,&nbsp;Hiroaki Miyata,&nbsp;Yuki Homma,&nbsp;Takafumi Kumamoto,&nbsp;Ryusei Matsuyama,&nbsp;Yoshihiro Kakeji,&nbsp;Yuko Kitagawa,&nbsp;Yasuyuki Seto\",\"doi\":\"10.1002/ags3.12745\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aim</h3>\\n \\n <p>We explored institutional factors in Japan associated with lower operative mortality and failure-to-rescue (FTR) rates for eight major gastrointestinal procedures.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A 22-item online questionnaire was sent to 2119 institutional departments (IDs) to examine the association between institutional factors and operative mortality and FTR rates. IDs were classified according to the number of annual surgeries, board certification status, and locality. In addition, the top 20% and bottom 20% of IDs were identified based on FTR rates and matched with the results of the questionnaire survey. Factors associated with operative mortality were selected by multivariate analysis.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Of the 1083 IDs that responded to the questionnaire, 568 (213 382 patients) were included in the analysis. Operative morbidity, operative mortality, and FTR rates in the top 20% and bottom 20% of IDs were 13.1% and 8.4% (<i>p</i> &lt; 0.001), 0.52% and 4.3% (<i>p</i> &lt; 0.001), and 4.0% and 51.2% (<i>p</i> &lt; 0.001), respectively. Based on the patients' background characteristics, the top 20% of IDs handled more advanced cases. No significant difference in locality was seen between better or worse hospital FTR rates, but fewer esophagectomies, hepatectomies, and pancreatoduodenectomies were performed in depopulated areas. Six items were found to be associated with operative mortality by multivariate logistic analysis. Only 50 (8.8%) IDs met all five factors related to better FTR rates.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>The present findings indicate that several hospital factors surrounding surgical treatment, characterized by abundant human resources, are closely related to better postoperative recovery from severe complications.</p>\\n </section>\\n </div>\",\"PeriodicalId\":8030,\"journal\":{\"name\":\"Annals of Gastroenterological Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2023-10-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12745\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Gastroenterological Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/ags3.12745\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Gastroenterological Surgery","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ags3.12745","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

目的 我们探讨了日本八种主要胃肠道手术中与较低手术死亡率和抢救失败率(FTR)相关的机构因素。 方法 向 2119 个机构部门(ID)发送了一份包含 22 个项目的在线问卷,以研究机构因素与手术死亡率和抢救失败率之间的关联。根据年度手术数量、委员会认证状况和地区对科室进行了分类。此外,还根据FTR率确定了前20%和后20%的ID,并与问卷调查结果进行了比对。通过多变量分析筛选出与手术死亡率相关的因素。 结果 在回复问卷的 1083 家 ID 中,有 568 家(213 382 名患者)被纳入分析范围。排名前 20% 和后 20% 的 ID 的手术发病率、手术死亡率和 FTR 率分别为 13.1% 和 8.4% (p <0.001)、0.52% 和 4.3% (p <0.001)、4.0% 和 51.2% (p <0.001)。根据患者的背景特征,排名前 20% 的 ID 处理了更多的晚期病例。较好或较差医院的 FTR 率在地区上没有明显差异,但人口稀少地区的食管切除术、肝切除术和胰十二指肠切除术较少。通过多变量逻辑分析发现,有六个项目与手术死亡率有关。只有 50 个(8.8%)ID 符合与更好的 FTR 率相关的所有五个因素。 结论 本研究结果表明,以人力资源丰富为特点的外科治疗周围的几个医院因素与术后严重并发症的恢复密切相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

摘要图片

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Requirements for hospitals in Japan to have low operative mortality and failure-to-rescue rates

Aim

We explored institutional factors in Japan associated with lower operative mortality and failure-to-rescue (FTR) rates for eight major gastrointestinal procedures.

Methods

A 22-item online questionnaire was sent to 2119 institutional departments (IDs) to examine the association between institutional factors and operative mortality and FTR rates. IDs were classified according to the number of annual surgeries, board certification status, and locality. In addition, the top 20% and bottom 20% of IDs were identified based on FTR rates and matched with the results of the questionnaire survey. Factors associated with operative mortality were selected by multivariate analysis.

Results

Of the 1083 IDs that responded to the questionnaire, 568 (213 382 patients) were included in the analysis. Operative morbidity, operative mortality, and FTR rates in the top 20% and bottom 20% of IDs were 13.1% and 8.4% (p < 0.001), 0.52% and 4.3% (p < 0.001), and 4.0% and 51.2% (p < 0.001), respectively. Based on the patients' background characteristics, the top 20% of IDs handled more advanced cases. No significant difference in locality was seen between better or worse hospital FTR rates, but fewer esophagectomies, hepatectomies, and pancreatoduodenectomies were performed in depopulated areas. Six items were found to be associated with operative mortality by multivariate logistic analysis. Only 50 (8.8%) IDs met all five factors related to better FTR rates.

Conclusions

The present findings indicate that several hospital factors surrounding surgical treatment, characterized by abundant human resources, are closely related to better postoperative recovery from severe complications.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Annals of Gastroenterological Surgery
Annals of Gastroenterological Surgery GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.30
自引率
11.10%
发文量
98
审稿时长
11 weeks
期刊最新文献
Issue Information Laparoscopic median arcuate ligament release using an anterior approach for median arcuate ligament syndrome Issue Information Essential updates 2022–2023: Surgical and adjuvant therapies for locally advanced colorectal cancer Phase II study of long-course chemoradiotherapy followed by consolidation chemotherapy as total neoadjuvant therapy in locally advanced rectal cancer in Japan: ENSEMBLE-2
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1