Notice bibliographique
Résumé
Introduction and Objectives: Surgical wait times have become a contentious quality indicator in universal health care systems.The potential for cannibalization towards higher priority surgical cases has led to concerns for the inevitable prolonged wait times for non-priority urologic procedures.We describe and evaluate the effect of surgical wait times on the early outcomes and peri-operative complications after transurethral resection of the prostate (TURP).Methods: Patients undergoing TURP for benign disease at a single centre in 2008 were included in this study.Wait times were determined utilizing a prospectively collected administrative database reporting a summary wait time from the time of OR booking to completion of surgery.Clinical data was supplemented by extensive chart review and included patient characteristics such as age, co-morbidity (ASA score) and indication for surgery.Associated outcomes investigated included additional hospitalization or urgent care visits while on the wait list, successful postoperative trial of voiding and complications within three months of surgery.Results: Eighty-four patients with a mean age of 73 were identified having a TURP for benign disease and 46% of patients presented with urinary retention.Mean surgical wait time for the cohort was 59 +/-48 days and there was no significant association with wait times and age or ASA score (Spearman correlation, 0.200, p = 0.07, 0.066, p = 0.547 respectively).There did not appear to be significant triaging of patients based on a presentation of urinary retention.Additional hospital visits for urologic complications was associated with prolonged wait times for TURP (p = 0.03, t-test); however, lower wait times for TURP was significantly associated with early failures of voiding and early postoperative complications (p = 0.02, p = 0.03 respectively; t-test).Dichotomizing wait time data at the median of 48 days confirmed that longer waits for TURP lead decreased postoperative complications (p = 0.033; chi square), including early failures of spontaneous voiding (p = 0.005; chi square) but was led to increased health care visits while waiting for surgery (p = 0.038; chi square).Subset analysis demonstrated that these results appeared to be driven mostly by those with a presentation of urinary retention.Conclusions: Prolonged wait times for urologic surgery are distressing for patients and can be a quality indicator of health care delivery.This retrospective study suggests that modest delays to TURP did not negatively affect early outcomes and, in fact, shorter wait times were associated with higher postoperative complications.However, these findings need to be balanced with higher likelihood of complications and resource utilization during the prolonged waits for surgery.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,002 | 0,000 |
| Communication savante | 0,003 | 0,001 |
| Science ouverte | 0,001 | 0,004 |
| Intégrité de la recherche | 0,005 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,596 | 0,240 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».