A carregar...
Publicação
AVC isquémico agudo em Portugal: a relação entre o volume e os resultados em trombectomia mecânica nos hospitais públicos portugueses em 2017
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 809.03 KB | Adobe PDF |
Autores
Orientador(es)
Resumo(s)
RESUMO - Enquadramento: Inúmeros estudos realizados desde há vários anos reforçam a
premissa de que o volume hospitalar influência os resultados em saúde. Apesar de se
verificar em muitos procedimentos, esta premissa não é válida para todos os
procedimentos analisados, sendo um tema até à data parco em estudos realizados em
Portugal. O objetivo da corrente investigação foi de avaliar a relação entre o volume
hospitalar de trombectomias mecânicas e os resultados em saúde nos hospitais públicos
de Portugal continental no ano de 2017, particularmente da mortalidade intra-hospitalar,
a presença de pelo menos uma complicação e a duração do internamento.
Metodologia: Foi realizado um estudo observacional, transversal, analítico com recolha
de informação retrospetiva através da base de dados de morbilidade hospitalar cedida
pela Administração Central do Sistema de Saúde (ACSS). Selecionaram-se todos os
episódios correspondentes à presença de trombectomia mecânica e aplicados critérios
de exclusão. Os hospitais abrangidos por este estudo foram categorizados tendo em
conta o volume anual de trombectomias mecânicas.
Resultados: Analisaram-se 1535 episódios de utentes submetidos a trombectomia
mecânica em 12 hospitais públicos portugueses. Após a análise bivariável e respetivo
ajustamento pelo risco, apenas a duração do internamento é influenciada pelo volume
hospitalar, sendo que com o aumento do volume hospitalar o tempo de internamento
diminui.
Conclusão: Apesar de não ser um tema novo, não existem estudos realizados em
Portugal avaliando a existência de uma relação entre o volume hospitalar de
trombectomias mecânicas e os resultados em saúde. Sendo importante não retirar
conclusões precipitadas face aos resultados obtidos neste tipo de estudos, sem antes
considerar todos os fatores que podem fazer variar os resultados em saúde avaliados.
É imperativo desenvolver o tema não só para o caso da trombectomia mecânica, mas
também para outros procedimentos que podem beneficiar deste tipo de análise.
ABSTRACT - Background: Countless studies carried out for several years reinforce the premise that hospital volume influences health outcome. Despite this relationship being found in many procedures, this premise is not valid for all the analyzed procedures, being a scarce topic in studies carried out in Portugal. The objective of the current investigation was to asess the relationship between the hospital volume of mechanical thrombectomies and the health outcomes in mainland Portugal in 2017, particularly in-hospital mortality, the presence of at least one complication and the duration of internment. Methods: An observational, cross-sectional, analytical study was carried out with the collection of retrospective information through the hospital morbidity database provided by the Central Administration of the Health System (ACSS). All episodes corresponding to the presence of mechanical thrombectomy were selected and exclusion criteria were applied. The hospitals covered by this study were categorized taking into account the annual volume of mechanical thrombectomies. Results: 1535 episodes of patients undergoing mechanical thrombectomy were analyzed in 12 Portuguese public hospitals. After the bivariate analysis and respective risk adjustment, only the length of hospital stay is influenced by the hospital volume, and with the increase in hospital volume, the length of hospital stay decreases. Conclusion: Although not a new topic, there are no studies carried out in Portugal evaluating the existence of a relationship between the hospital volume of mechanical thrombectomies and health outcomes. It is important not to jump to conclusions in view of the results obtained in this type of studies, without first considering all the factors that may vary the health outcomes evaluated. It is imperative to develop the theme not only for the case of mechanical thrombectomy, but also for other procedures that can benefit from this type of analysis.
ABSTRACT - Background: Countless studies carried out for several years reinforce the premise that hospital volume influences health outcome. Despite this relationship being found in many procedures, this premise is not valid for all the analyzed procedures, being a scarce topic in studies carried out in Portugal. The objective of the current investigation was to asess the relationship between the hospital volume of mechanical thrombectomies and the health outcomes in mainland Portugal in 2017, particularly in-hospital mortality, the presence of at least one complication and the duration of internment. Methods: An observational, cross-sectional, analytical study was carried out with the collection of retrospective information through the hospital morbidity database provided by the Central Administration of the Health System (ACSS). All episodes corresponding to the presence of mechanical thrombectomy were selected and exclusion criteria were applied. The hospitals covered by this study were categorized taking into account the annual volume of mechanical thrombectomies. Results: 1535 episodes of patients undergoing mechanical thrombectomy were analyzed in 12 Portuguese public hospitals. After the bivariate analysis and respective risk adjustment, only the length of hospital stay is influenced by the hospital volume, and with the increase in hospital volume, the length of hospital stay decreases. Conclusion: Although not a new topic, there are no studies carried out in Portugal evaluating the existence of a relationship between the hospital volume of mechanical thrombectomies and health outcomes. It is important not to jump to conclusions in view of the results obtained in this type of studies, without first considering all the factors that may vary the health outcomes evaluated. It is imperative to develop the theme not only for the case of mechanical thrombectomy, but also for other procedures that can benefit from this type of analysis.
Descrição
Palavras-chave
Volume hospitalar Trombectomia Mecânica Acidente Vascular Cerebral Resultados em saúde Qualidade em saúde Hospital Volume Mechanical Thrombectomy Stroke Health Outomes Health Quality