Organizational problems and possible ways of its resolve when providing emergency surgical care to patients with comorbid status in a highly specialized medical institution
Purpose of the study. To demonstrate the difficulties of objective interpretation of providing medical care to patients with critical limb ischemia.Materials and methods. The results of treatment of more than 29 thousand patients of one of the highly specialized medical organizations of St. Petersbu...
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| Format: | Article |
| Language: | Russian |
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QUASAR, LLC
2020-06-01
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| Series: | Issledovaniâ i Praktika v Medicine |
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| Online Access: | https://www.rpmj.ru/rpmj/article/view/540 |
| _version_ | 1797874056907718656 |
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| author | I. M. Khokhlova V. B. Kozhevnikov K. N. Movchan B. S. Artyushin E. V. Bartashevich A. V. Zharkov E. V. Zheleznyi |
| author_facet | I. M. Khokhlova V. B. Kozhevnikov K. N. Movchan B. S. Artyushin E. V. Bartashevich A. V. Zharkov E. V. Zheleznyi |
| author_sort | I. M. Khokhlova |
| collection | DOAJ |
| description | Purpose of the study. To demonstrate the difficulties of objective interpretation of providing medical care to patients with critical limb ischemia.Materials and methods. The results of treatment of more than 29 thousand patients of one of the highly specialized medical organizations of St. Petersburg were studied, in which the main activity of the staff is the examination of patients with surgical infection of soft tissues (particularly, the critical limb ischemia).Results. It has been ascertained that, despite the unconditional success of providing medical care to patients with critical limb ischemia, a high frequency of unsatisfactory treatment results for this category of patients remains (in 2017, among 685 patients of the specialized department of the highly specialized medical organization, the proportion of cases of performing high amputations of limbs and mortality, respectively, was 11,7% (80) and 2,6% (18)). It has been demonstrated on clinical examples that the pronounced comorbidity of critical limb ischemia patients and the severity of their general condition (combined with organizational difficulties in providing them with providing medical care in conditions of highly specialized medical organization) contribute to the formation of complications (up to lethal outcomes) of not only the underlying, but also concomitant diseases. Difficulties in providing medical care of adequate quality in life-threatening conditions for patients of highly specialized medical organization in cases of critical limb ischemia necessitate a wider interaction between specialists in narrow and multidisciplinary hospitals as part of the emergency surgery service.Conclusion. When creating specialized medical centers outside of multidisciplinary medical institutions, the possibilities should be provided for the regulated involvement of highly professional consultants with a reasonable algorithm for routing patients in cases of the need for their emergency re-hospitalization to other medical institutions. |
| first_indexed | 2024-04-10T01:25:54Z |
| format | Article |
| id | doaj.art-51d1028c73d94f8388644f0daecd0443 |
| institution | Directory Open Access Journal |
| issn | 2410-1893 |
| language | Russian |
| last_indexed | 2024-04-10T01:25:54Z |
| publishDate | 2020-06-01 |
| publisher | QUASAR, LLC |
| record_format | Article |
| series | Issledovaniâ i Praktika v Medicine |
| spelling | doaj.art-51d1028c73d94f8388644f0daecd04432023-03-13T09:35:01ZrusQUASAR, LLCIssledovaniâ i Praktika v Medicine2410-18932020-06-0172647410.17709/2409-2231-2020-7-2-6321Organizational problems and possible ways of its resolve when providing emergency surgical care to patients with comorbid status in a highly specialized medical institutionI. M. Khokhlova0V. B. Kozhevnikov1K. N. Movchan2B. S. Artyushin3E. V. Bartashevich4A. V. Zharkov5E. V. Zheleznyi6СПб ГБУЗ «Городская больница №14»; СПб ГБУЗ «Медицинский информационно-аналитический центр»СПб ГБУЗ «Городская больница №14»; ФГБОУ ВО «Северо-Западный государственный медицинский университет имени И.И. Мечникова» Министерства здравоохранения Российской ФедерацииФГБОУ ВО «Северо-Западный государственный медицинский университет имени И.И. Мечникова» Министерства здравоохранения Российской Федерации; СПб ГБУЗ «Медицинский информационно-аналитический центр»СПб ГБУЗ «Медицинский информационно-аналитический центр»СПб ГБУЗ «Медицинский информационно-аналитический центр»СПб ГБУЗ «Медицинский информационно-аналитический центр»СПб ГБУЗ «Медицинский информационно-аналитический центр»Purpose of the study. To demonstrate the difficulties of objective interpretation of providing medical care to patients with critical limb ischemia.Materials and methods. The results of treatment of more than 29 thousand patients of one of the highly specialized medical organizations of St. Petersburg were studied, in which the main activity of the staff is the examination of patients with surgical infection of soft tissues (particularly, the critical limb ischemia).Results. It has been ascertained that, despite the unconditional success of providing medical care to patients with critical limb ischemia, a high frequency of unsatisfactory treatment results for this category of patients remains (in 2017, among 685 patients of the specialized department of the highly specialized medical organization, the proportion of cases of performing high amputations of limbs and mortality, respectively, was 11,7% (80) and 2,6% (18)). It has been demonstrated on clinical examples that the pronounced comorbidity of critical limb ischemia patients and the severity of their general condition (combined with organizational difficulties in providing them with providing medical care in conditions of highly specialized medical organization) contribute to the formation of complications (up to lethal outcomes) of not only the underlying, but also concomitant diseases. Difficulties in providing medical care of adequate quality in life-threatening conditions for patients of highly specialized medical organization in cases of critical limb ischemia necessitate a wider interaction between specialists in narrow and multidisciplinary hospitals as part of the emergency surgery service.Conclusion. When creating specialized medical centers outside of multidisciplinary medical institutions, the possibilities should be provided for the regulated involvement of highly professional consultants with a reasonable algorithm for routing patients in cases of the need for their emergency re-hospitalization to other medical institutions.https://www.rpmj.ru/rpmj/article/view/540узкопрофильный стационаркритическая ишемия нижних конечностейампутация нижних конечностейкачество медицинской помощиполиморбидностьрегоспитализация |
| spellingShingle | I. M. Khokhlova V. B. Kozhevnikov K. N. Movchan B. S. Artyushin E. V. Bartashevich A. V. Zharkov E. V. Zheleznyi Organizational problems and possible ways of its resolve when providing emergency surgical care to patients with comorbid status in a highly specialized medical institution Issledovaniâ i Praktika v Medicine узкопрофильный стационар критическая ишемия нижних конечностей ампутация нижних конечностей качество медицинской помощи полиморбидность регоспитализация |
| title | Organizational problems and possible ways of its resolve when providing emergency surgical care to patients with comorbid status in a highly specialized medical institution |
| title_full | Organizational problems and possible ways of its resolve when providing emergency surgical care to patients with comorbid status in a highly specialized medical institution |
| title_fullStr | Organizational problems and possible ways of its resolve when providing emergency surgical care to patients with comorbid status in a highly specialized medical institution |
| title_full_unstemmed | Organizational problems and possible ways of its resolve when providing emergency surgical care to patients with comorbid status in a highly specialized medical institution |
| title_short | Organizational problems and possible ways of its resolve when providing emergency surgical care to patients with comorbid status in a highly specialized medical institution |
| title_sort | organizational problems and possible ways of its resolve when providing emergency surgical care to patients with comorbid status in a highly specialized medical institution |
| topic | узкопрофильный стационар критическая ишемия нижних конечностей ампутация нижних конечностей качество медицинской помощи полиморбидность регоспитализация |
| url | https://www.rpmj.ru/rpmj/article/view/540 |
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