摘要
目的分析目前版本的华西肠癌数据库(Database from Colorectal Cancer,DACCA)中,华西医院作为区域性医疗中心所服务的结直肠癌患者的住院流程管理的特点。方法本次数据分析选取的DACCA版本为2019年1月29日更新版,其中数据项目包括:就诊日期、入院日期、手术日期、出院日期、入院前等候时间、术前住院时间、术后住院时间、住院总时间及管理流程,分别对各选取的数据项目作特征分析。结果按照条件筛选DACCA数据库获得8 193条可分析数据行。其中,"就诊日期"有效数据3 915条,"入院日期"有效数据8 144条,"手术日期"有效数据8 049条,"出院日期"有效数据7 958条。入院前等待时间为(9.41±0.43)d,按照日期变化趋势的线性预测分析结果示,R^2=0.101 257,P<0.001。术前住院时间为(5.41±0.04)d,按照日期变化趋势的线性预测分析结果示,R^2=0.023 671,P<0.001。术后住院时间为(8.99±0.07)d,按照日期变化趋势的线性预测分析结果示, R^2=0.086 177,P<0.001。住院总时间为(14.43±0.08)d,按照日期变化趋势的线性预测分析结果示,R^2=0.098 44,P<0.001。DACCA数据库中可以分析的有效ERAS数据为2 368条,其中可以达到分析条件的完全ERAS数据2 368条,顺利实施108条(5%),未顺利实施2 260条(95%);达到分析条件的围手术期ERAS数据2 260条,顺利实施150条(7%),未顺利实施2 110条(93%);达到分析条件的术后ERAS数据2 110条,顺利实施170条(8%),未顺利实施1 940条(92%)。结论 DACCA数据库反映近20年来,本中心住院患者的术前等待、术后观察和住院总时间有下降趋势,服务结直肠癌患者的总体能力提高。ERAS在本中心的临床应用度升高,并逐步成为最主要的住院管理流程。
Objective Based on recently update Database from Colorectal Cancer(DACCA),we aimed to analyze the characteristics of in-hospital process management from reginal medical center's colorectal cancer patients.Methods We used Version January 29th,2019 of DACAA being the analyzing source.The items were included date of first out-patient meeting,admitted date,operative date,discharged date,waiting-time,preoperative staying days,postoperative staying days,hospital staying days,and manage protocol,whose characteristics would be analyzed.Results We left 8 913 lines to be analyzed by filtering DACCA.Useful data lines of first out-patient meeting had 3 915,admitted date had 8 144,operative date had 8 049,and discharged date had 7 958.The average of waiting-time were(9.41±0.43)days,and based on timeline trend for line prediction analyzing,which showed R^2=0.101 257,P<0.001.The average of preoperative staying days were(5.41±0.04)days,and based on timeline trend for line prediction analyzing,which showed R^2=0.023 671,P<0.001.The average of postoperative staying days were(8.99±0.07)days,and based on timeline trend for line prediction analyzing,which showed R^2=0.086 177,P<0.001.The average of hospital staying days were(14.43±0.08)days,and based one timeline trend of line prediction analyzing,which showed R^2=0.098 44,PvO.OOl.Analyzable ERAS data were 2 368 lines in DACCA.Total EARS data in 2 368 lines,there were 108 lines(5%)completed and 2 260 lines(95%)incomplete.Pre/post ERAS data in 2 260 lines,there were 150 lines(7%)completed and 2 110 lines(93%)incomplete.Post ERAS data in 2 110 lines,there were 170 lines(8%)completed and 1 940 lines(92%)incomplete.Conclusions In recent 20 years,the regional medical center served in-hospital colorectal cancer patients with decreased preoperative staying days,postoperative staying days,and in-hospital staying days from DACCA analyzing,which could prove the service ability had been in improved.Utilization rate of EARS was increased,and also being the main in-hospital process management.
作者
汪晓东
安丽珉
李立
WANG Xiaodong;AN Limin;Li Li(Department of Gastrointestinal Surgery,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;West China School of Medicine in Sichuan University,Chengdu 610041,P.R.China)
出处
《中国普外基础与临床杂志》
CAS
2019年第4期469-475,共7页
Chinese Journal of Bases and Clinics In General Surgery
基金
四川科技厅科普培训项目(项目编号:2018KZ0029)
关键词
结直肠癌
数据库
大数据
医疗流程
加速康复外科
colorectal cancer
database
bigdata
medical process
enhanced recovery after surgery
