胃肠内镜手术的常规并发症发生率可能低估了手术后计划外住院(UHVs)所代表的更广泛的风险。我们的目标是从2014年到2018年在马里兰州和哥伦比亚特区的程序描述UHVs。
■所有食管胃十二指肠镜检查(EGD)的数据,结肠镜检查,联合EGD/结肠镜检查,2014年至2018年期间进行的内镜逆行胰胆管造影术(ERCPs)由马里兰州健康信息交换中心(ChesapeakeRegionalInformationSystemforourPatients)提供.患者人口统计学,术后14天内的特高压时间,旅行距离,设施站点(“家庭”与“远离”机构),和国际疾病分类代码的特高压进行了分析。仅包括可能归因于内窥镜程序的UHV。
■在304,786次内窥镜手术和3904次计划外就诊中,14天特高压率为1.7%,0.6%,1.3%,EGD为5.2%,结肠镜检查,联合EGD/结肠镜检查,和ERCP程序。从2014年到2018年,除ERCP增加外,所有程序类型的特高压年率都保持稳定。经历过UHV的患者在性别上有统计学差异,种族,年龄,和旅行的距离。UHV最常见于术后第1天;急诊就诊最常见。所有程序的UHV,除了ERCP,更有可能发生在“家庭”机构。总的来说,患者更有可能在“远离”机构接受手术后。
■内镜手术后超高压率普遍较低。然而,EGD和结肠镜检查的UHV发生率明显高于常规并发症发生率。由于所有计划外访问的30%-60%发生在“远离”机构,内镜医师应考虑采用广泛的方法来检测术后并发症,而不应依赖单一机构进行数据采集.
UNASSIGNED: Conventional complication rates for gastrointestinal endoscopic procedures may underestimate the broader risk represented by postprocedure unplanned hospital visits (UHVs). We aimed to characterize UHVs for procedures in
Maryland and the District of Columbia from 2014 to 2018.
UNASSIGNED: Data for all esophagogastroduodenoscopies (EGDs), colonoscopies, combined EGDs/colonoscopies, and endoscopic retrograde cholangiopancreatographies (ERCPs) performed between 2014 and 2018 was provided by the
Maryland Health Information Exchange (Chesapeake Regional Information System for our Patients\'). Patient demographics, timing of UHV within 14 days postprocedure, distance traveled, facility site (\"home\" vs \"away\" institution), and International Classification of Diseases codes for the UHV were analyzed. Only UHVs potentially attributable to the endoscopic procedures were included.
UNASSIGNED: Among 304,786 endoscopic procedures and 3904 unplanned visits, the 14-day UHV rates were 1.7%, 0.6%, 1.3%, and 5.2% for EGD, colonoscopy, combined EGD/colonoscopy, and ERCP procedures respectively. From 2014 to 2018, the UHV rate on an annual basis remained stable for all procedure types except for ERCPs which increased. Patients who experienced UHVs were statistically different in sex, race, age, and distance traveled. UHVs most often occurred on postprocedure day 1; emergency department visits occurred most commonly. UHVs for all procedures, except ERCPs, were more likely to occur at a \"home\" institution. Overall, patients were more likely to be admitted postprocedure at an \"away\" institution.
UNASSIGNED: Postendoscopic procedure UHV rates were generally low. However, UHV rates for EGDs and colonoscopies were significantly higher than conventional complication rates. As 30%-60% of all unplanned visits occurred at an \"away\" institution, endoscopists should consider a broad approach to detecting postprocedure complications and not rely on a single institution for data capture.