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首页> 外文期刊>Surgical Endoscopy >The quality of cholecystectomy in Denmark: outcome and risk factors for 20,307 patients from the national database.
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The quality of cholecystectomy in Denmark: outcome and risk factors for 20,307 patients from the national database.

机译：丹麦的胆囊切除术质量：国家数据库中20307例患者的结局和危险因素。

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BACKGROUND: Laparoscopic cholecystectomy is the standard treatment for symptomatic gallstones. The quality of the procedure frequently is included in quality improvement programs, but outcome values have not been described to define the standard of care for a general population. This study included 20,307 cholecystectomies from a national prospective database that combines administrative data with clinical data. This report states the quality of cholecystectomy in Denmark, establishes benchmarks, and identifies significant risk factors. METHODS: The Danish Cholecystectomy Database was queried for data from 2006 to 2009. The outcome measures included conversion rate, hospital length of stay (LOS), readmission, additional procedures, and 30-day mortality. Patient characteristics and operative findings were analyzed as risk factors using stepwise backward logistic regression. RESULTS: The study included 20,307 patients (82% of all cholecystectomies). The conversion rate was 7.6%. Male sex, acute cholecystitis, and previous upper abdominal surgery were risk factors for conversion, with respective odds ratios of 1.50, 4.61, and 3.54. The mean LOS was 1.5 days, and 37.3% of the patients had same-day surgery. The readmission rate was 9.6%. Nearly 70% had a LOS of 1 day or less and no readmission; 17.3% had a LOS longer than 3 days and/or readmission; 5.6% had an additional procedure within 30 days; and 0.2% had a bile duct injury requiring reconstructive surgery. The 30-day mortality rate was 0.27%. Age older than 60 years, American Society of Anesthesiology (ASA) score exceeding 1, and open procedure were significant risk factors for all the outcomes. Body mass index (BMI) was not a risk factor for any of the outcomes. CONCLUSION: The quality of cholecystectomy is high in Denmark, with a low conversion rate and a high frequency of short admissions without readmission. Acute cholecystitis and open procedure are important risk factors for poorer outcomes.The results of this study analyzing a large, unbiased population can be used to benchmark outcomes of cholecystectomy.
机译：背景：腹腔镜胆囊切除术是有症状胆结石的标准治疗方法。该过程的质量通常包含在质量改进计划中，但尚未描述结果值来定义普通人群的护理标准。这项研究包括来自全国前瞻性数据库的20307例胆囊切除术，该数据库将行政数据与临床数据相结合。该报告阐明了丹麦的胆囊切除术的质量，建立了基准并确定了重要的危险因素。方法：查询丹麦胆囊切除术数据库的2006年至2009年的数据。结果指标包括转化率，住院时间（LOS），再入院，附加手术和30天死亡率。使用逐步后向逻辑回归分析分析患者特征和手术结果作为危险因素。结果：该研究包括20,307例患者（占所有胆囊切除术的82％）。转化率为7.6％。男性，急性胆囊炎和以前的上腹部手术是发生转化的危险因素，其优势比分别为1.50、4.61和3.54。平均LOS为1.5天，并且37.3％的患者接受了当天手术。再入院率为9.6％。近70％的LOS为1天或更短时间，并且没有再次入院; 17.3％的LOS超过3天和/或再入院; 5.6％在30天内进行了额外的程序; 0.2％的胆管损伤需要重建手术。 30天死亡率为0.27％。年龄超过60岁，美国麻醉学会（ASA）得分超过1，开放手术是所有预后的重要危险因素。体重指数（BMI）并非任何结果的危险因素。结论：丹麦的胆囊切除术质量高，转换率低，短期入院率高，无再次入院。急性胆囊炎和开放手术是导致预后较差的重要危险因素。本研究的结果是，分析了一大批无偏见的人群，可将其作为胆囊切除术预后的基准。

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