Objective To analyze the basic characteristics of hospitalized patients with colorectal cancer (CRC), to estimate the hospitalization scale, medical resource utilization, and cross-regional hospitalization of CRC inpatients in Sichuan Province, which will provide data support for scientifically formulating colorectal cancer medical resource allocation measures. Methods Based on the hospital discharge records of CRC inpatients collected from secondary hospitals and tertiary hospitals in Sichuan Province between 2015 and 2019, descriptive statistical analysis was performed and the cross-geographical hospitalizations was visualized using a directed network. Results During the study period, the number of CRC inpatients and hospitalizations increased with time. The average age of CRC inpatients in 2019 was 65.1 years, an increase of 1.5 years in the 5-year-period. The proportion of men was relatively high (about 60.1%) and remained stable in the 5-year-period. The median length-of-stay of CRC inpatients per year was 25 days (IQR: 13 days, 45 days), and inpatients in urban areas were 2 days longer than that in rural areas. The median hospitalization cost of CRC inpatients per year was 32 900 yuan (IQR: 11 200 yuan, 59 300 yuan), men were 500 yuan higher than women, and patients in urban areas were 9 900 yuan higher than that in rural areas. From 2016 to 2019, 13.9% hospitalizations (59 512 hospitalizations) were cross-geographical hospitalizations, where Chengdu had the lowest outflow rate (1.0%) and the highest inflow rate (29.3%). Conclusions CRC inpatients showed an aging trend, and the number of hospitalizations and annual hospitalization costs increased year by year. Cross-geographical hospitalizations mainly flow to the provincial medical center and a small part flow to the regional medical centers.
【摘要】 目的 了解四川省医护人员工作倦怠状况，分析其影响因素，为卫生行政管理部门进行有效的预防和干预提供依据。 方法 2008年8月采用分层随机抽样方法，对2 588名医护人员进行调查。 结果 有明显工作倦怠感的医护人员占被调查人员总数的1/4，其年龄、性别、文化程度、职称、专业类别与专业工作年数、行政业务管理职务与医疗机构级别等是影响工作倦怠的主要因素。 结论 优化医院人员配置，营造良好的工作环境和条件，重视和加强对医护人员专业知识、技能培训，对医护人员的工作付出及时予以积极评价等，是避免和降低医护人员工作倦怠的有效措施。【Abstract】 Objective To understand the situation of job burnout and its influential factors among doctors and nurses of Sichuan province and so as to provide evidences for relative departments to prevent job burnout. Methods Stratified random sampling was adopted to investigate 2588 doctors and nurses in August, 2008. Results The percentage of doctors and nurses with evident job burnout in Sichuan province was about 25%. And it was mainly affected by sex, age, education level, job title, job specialty, work experience, administration duty and level of medical institution. Conclusion Relative departments should emphasize on optimizing personnel combination, constructing favorable work condition, reinforcing professional knowledge and skill training, commending work achievement in time in order to avoid and reduce job burnout of doctors and nurses effectively.
ObjectiveTo understand the impact of preoperative nutritional status on the postoperative complications for patients with low/ultra-low rectal cancer undergoing extreme sphincter-preserving surgery following neoadjuvant therapy. MethodsThe patients with low/ultra-low rectal cancer who underwent extreme sphincter-preserving surgery following neoadjuvant therapy from January 2009 to December 2020 were retrospectively collected using the Database from Colorectal Cancer (DACCA), and then who were assigned into a nutritional risk group (the score was low than 3 by the Nutrition Risk Screening 2002) and non-nutritional risk group (the score was 3 or more by the Nutrition Risk Screening 2002). The postoperative complications and survival were analyzed for the patients with or without nutritional risk. The postoperative complications were defined as early-term (complications occurring within 30 d after surgery), middle-term (complications occurring during 30–180 d after surgery), and long-term (complications occurring at 180 d and more after surgery). The survival indicators included overall survival and disease-specific survival. ResultsA total of 680 patients who met the inclusion criteria for this study were retrieved from the DACCA database. Among them, there were 500 (73.5%) patients without nutritional risk and 180 (26.5%) patients with nutritional risk. The postoperative follow-up time was 0–152 months (with average 48.9 months). Five hundreds and forty-three survived, including 471 (86.7%) patients with free-tumors survival and 72 (13.3%) patients with tumors survival. There were 137 deaths, including 122 (89.1%) patients with cancer related deaths and 15 (10.9%) patients with non-cancer related deaths. There were 48 (7.1%) cases of early-term postoperative complications, 51 (7.5%) cases of middle-term complications, and 17 (2.5%) cases of long-term complications. There were no statistical differences in the incidence of overall complications between the patients with and without nutritional risk (χ2=3.749, P=0.053; χ2=2.205, P=0.138; χ2=310, P=0.578). The specific complications at different stages after surgery (excluding the anastomotic leakage complications in the patients with nutritional risk was higher in patients without nutritional risk, P=0.034) had no statistical differences between the two groups (P>0.05). The survival curves (overall survival and disease-specific survival) using the Kaplan-Meier method had no statistical differences between the patients with and without nutritional risk (χ2=3.316, P=0.069; χ2=3.712, P=0.054). ConclusionsFrom the analysis results of this study, for the rectal cancer patients who underwent extreme sphincter-preserving surgery following neoadjuvant therapy, the patients with preoperative nutritional risk are more prone to anastomotic leakage within 30 d after surgery. Although other postoperative complications and long-term survival outcomes have no statistical differences between patients with and without nutritional risk, preoperative nutritional management for them cannot be ignored.