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首页> 外文期刊>Annals of Gastroenterological Surgery >Clinical impact of developing better practices at the institutional level on surgical outcomes after distal pancreatectomy in 1515 patients: Domestic audit of the Japanese Society of Pancreatic Surgery
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Clinical impact of developing better practices at the institutional level on surgical outcomes after distal pancreatectomy in 1515 patients: Domestic audit of the Japanese Society of Pancreatic Surgery

机译：在机构一级制定更好的实践对1515例远端胰腺切除术后手术结局的临床影响：日本胰腺外科学会的国内审计

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Background and Aim Institutional standardization in the perioperative management of distal pancreatectomy (DP) has not been evaluated in a multicenter setting. The aim of the present study was to assess the influence of institutional standardization on the development of postoperative complications after DP. Methods Data were collected from 1515 patients who underwent DP in 2006, 2010, and 2014 at 53 institutions in Japan. A standardized institution (SI) was defined as one that implemented ≥6 of 11 quality initiatives according to departmental policy. There were 541 patients in the SI group and 974 in the non‐SI group. Clinical parameters were compared between groups. Risk factors for morbidity and mortality were assessed by logistic regression analysis with a mixed‐effects model. Results Proportion of patients who underwent DP in SI increased from 16.5% in 2006 to 46.4% in 2014. The SI group experienced an improved process of care and a lower frequency of severe complications vs the non‐SI group (grade III/IV Clavien‐Dindo; 22% vs 29%, respectively, clinically relevant postoperative pancreatic fistula; 22% vs 31%, respectively.
机译：背景和目的尚未在多中心环境中评估远端胰腺切除术（DP）围手术期管理中的机构标准化。本研究的目的是评估机构标准化对DP术后并发症发展的影响。方法收集了2006年，2010年和2014年日本53家机构的1515例进行DP的患者的数据。标准化机构（SI）被定义为根据部门政策实施了11项质量计划中的≥6项的机构。 SI组有541例患者，非SI组有974例。比较各组之间的临床参数。通过采用混合效应模型的逻辑回归分析评估了发病率和死亡率的危险因素。结果接受DP的SI患者所占比例从2006年的16.5％增加到2014年的46.4％。与非SI组相比，SI组的护理过程得到改善，严重并发症的发生率更低（III / IV级克拉维恩Dindo;临床相关的术后胰瘘分别为22％和29％;分别为22％和31％。

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