The aim of this study was to retrospectively compare the long-term efficacy of MW ablation as a curative therapy for hepatocellular carcinoma(HCC) adjacent to large vessels(≥3 mm) with that in safe location. Between 2010 and 2016, 406 patients diagnosed with early-stage HCC at Chinese PLA general hospital were enrolled. One-to-one matched pairs between the vessel group and the safe group were generated using propensity score matching. The associations of treatment strategy with overall survival and local tumor progression were determined by Cox regression. Before matching, 113 patients were classified into the vessel group and 293 patients were classified into the vessel group. The patients in the vessel group were more frequently classified as larger tumor size (P<0.05) and higher AFP level (P<0.05) than patients in the safe group. After propensity score matching, 113 pairs of well-matched HCC patients were selected from different treatment groups. No significant differences were found in local tumor progression, overall survival and complication rates for MW ablation as a first-line treatment for the early-stage HCC between two groups. In conclusion, MW ablation provides an effective and safe way to treat early-stage HCC adjacent to large vessels.
Background
Accurate and timely clinical laboratory critical values notification are crucial steps in supporting effective clinical decision making, thereby improving patient safety.
Methods
A closed‐loop laboratory critical value notification system was developed by a multidisciplinary team of clinicians, laboratorians, administrators, and information technology experts. All the laboratory critical values that occurred at Beijing Tsinghua Changgung Hospital (BTCH, Beijing, China) from 2015 to 2019 were analyzed and studied retrospectively.
Results
The total number (ratio) of institutional laboratory critical values to all reported items at BTCH from 2015 to 2019 was 38 020/7 706 962 (0.49%). Percentage distribution points of critical value boundaries based on patients’ test reports are 0.007% ~ 6.04% for low boundaries and 71.70% ~ 99.99% for high boundaries. After the intervention, the timely notification ratio, notification receipt ratio, and timely notification receipt ratio of critical values of ED, IPD, and total patients had increased, with a significant difference (P < .001). Five quality indicators, such as notification ratio, timely notification ratio, notification receipt ratio, timely notification receipt ratio, and clinician response ratio over a 5‐year period, were 100%, 94%, 97%, 92%, and 99%, respectively.
Conclusions
We enhanced the effectiveness of clinical laboratory critical values initiative notification by implementing a closed‐loop system and intervening. Clinical critical values and quality indicators should be analyzed and monitored to avoid adversely affecting patient care.
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