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首页> 外文期刊>Surgical Endoscopy >Disease-based mortality after percutaneous endoscopic gastrostomy: utility of the enterprise data warehouse.
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Disease-based mortality after percutaneous endoscopic gastrostomy: utility of the enterprise data warehouse.

机译：经皮内镜下胃造口术后基于疾病的死亡率：企业数据仓库的实用性。

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Percutaneous endoscopic gastrostomy (PEG) remains a mainstay of enteral access. Thirty-day mortality for PEG has ranged from 16 to 43 %. This study aims to discern patient groups that demonstrate limited survival after PEG placement. The Enterprise Data Warehouse (EDW) concept allows an efficient means of integrating administrative, clinical, and quality-of-life data. On the basis of this concept, we developed the Vanderbilt Procedural Outcomes Database (VPOD) and analyzed these data for evaluation of post-PEG mortality over time.Patients were identified using the VPOD from 2008 to 2010 and followed for 1 year after the procedure. Patients were categorized according to common clinical groups for PEG placement: stroke/CNS tumors, neuromuscular disorders, head and neck cancers, other malignancies, trauma, cerebral palsy, gastroparesis, or other indications for PEG. All-cause mortality at 30, 60, 90, 180, and 360 days was determined by linking VPOD information with the Social Security Death Index. Chi-square analysis was used to determine significance across groups.Nine hundred fifty-three patients underwent PEG placement during the study period. Mortality over time (30-, 60-, 90-, 180-, and 360-day mortality) was greatest for patients with malignancies other than head and neck cancer (29, 45, 57, 66, and 72 %) and least for cerebral palsy or patients with gastroparesis (7 % at all time points). Patients with neuromuscular disorders had a similar mortality curve as head and neck cancer patients. Stroke/CNS tumor patients and patients with other indications had the second highest mortality, while trauma patients had low mortality.PEG mortality was much higher in patients with malignancies other than head and neck cancer compared to previously published rates. PEG should be used with great caution in this and other high-risk patient groups. This study demonstrates the power of an EDW-based database to evaluate large numbers of patients with clinically meaningful results.
机译：经皮内窥镜胃造口术（PEG）仍然是肠通路的支柱。 PEG的30天死亡率为16％至43％。这项研究旨在辨别在PEG植入后存活受限的患者群体。企业数据仓库（EDW）概念提供了一种有效的方式来集成管理，临床和生活质量数据。基于这一概念，我们开发了范德比尔特手术结局数据库（VPOD），并分析了这些数据以评估随时间推移发生的PEG死亡率.2008年至2010年使用VPOD识别患者，并在术后1年进行随访。根据常见的PEG放置临床组对患者进行了分类：中风/ CNS肿瘤，神经肌肉疾病，头颈癌，其他恶性肿瘤，创伤，脑瘫，胃轻瘫或其他PEG适应症。通过将VPOD信息与社会保障死亡指数相关联，确定30、60、90、180和360天的全因死亡率。卡方分析用于确定各组之间的显着性。在研究期间，有593例患者接受了PEG植入。随时间推移的死亡率（30、60、90、180和360天死亡率）对于除头颈癌以外的其他恶性肿瘤患者而言最高（29％，45％，57％，66％和72％），而对于其他疾病则最低。脑瘫或胃轻瘫患者（所有时间点均为7％）。神经肌肉疾病患者的死亡率曲线与头颈癌患者相似。中风/中枢神经系统肿瘤患者和其他适应症患者的死亡率第二高，而创伤患者的死亡率低。与先前公布的比率相比，头颈癌以外的恶性肿瘤患者的PEG死亡率要高得多。在此和其他高风险患者组中，应谨慎使用PEG。这项研究证明了基于EDW的数据库能够评估大量具有临床意义的患者。

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