麻醉科主导的重症监护外展服务和急性疼痛服务对术后严重不良事件的影响。

Effect of an anaesthesia department led critical care outreach and acute pain service on postoperative serious adverse events.

作者信息

Story D A, Shelton A C, Poustie S J, Colin-Thome N J, McIntyre R E, McNicol P L

机构信息

Department of Anaesthesia, The University of Melbourne, Austin Health, Melbourne, Victoria, Australia.

出版信息

Anaesthesia. 2006 Jan;61(1):24-8. doi: 10.1111/j.1365-2044.2005.04435.x.

DOI:10.1111/j.1365-2044.2005.04435.x

PMID:16409338

Abstract

UNLABELLED

We examined whether a combined critical care outreach and acute pain service comprising both medical and nursing staff from the Department of Anaesthesia would decrease the incidence of postoperative serious adverse events in a hospital with an established Medical Emergency Team. We called this combined service

IMPACT

Inpatient Management of acute Pain and Advice on Clinical Treatment. We conducted a prospective, before-and-after trial with a baseline phase (319 patients) of standard acute pain management followed by the IMPACT phase (271 patients), during which the IMPACT team systematically reviewed high-risk postoperative patients for the first three days after their return to the general wards. The incidence of serious adverse events decreased from 23 events per 100 patients to 16 events per 100 patients. The 30-day mortality decreased from 9% to 3%, p = 0.004. An acute pain service providing critical care outreach may improve postoperative outcome but the workload is considerable.

摘要

未标注

我们研究了由麻醉科医护人员组成的重症监护外展与急性疼痛综合服务，是否会降低一家已设立医疗急救团队的医院中术后严重不良事件的发生率。我们将这项综合服务称为“IMPACT：急性疼痛的住院管理与临床治疗建议”。我们进行了一项前瞻性前后对照试验，基线阶段（319例患者）采用标准急性疼痛管理，随后是IMPACT阶段（271例患者），在此期间，IMPACT团队在高危术后患者返回普通病房后的头三天对其进行系统评估。严重不良事件的发生率从每100例患者23起降至每100例患者16起。30天死亡率从9%降至3%，p = 0.004。提供重症监护外展的急性疼痛服务可能会改善术后结局，但工作量相当大。