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术后患者的抱怨:一项针对 12276 名患者的前瞻性访谈研究。

Postoperative patient complaints: a prospective interview study of 12,276 patients.

机构信息

Department of Anesthesia, University Hospital Basel, CH-4031 Basel, Switzerland.

出版信息

J Clin Anesth. 2010 Feb;22(1):13-21. doi: 10.1016/j.jclinane.2009.02.015.

Abstract

STUDY OBJECTIVE

To evaluate the incidence of perioperative minor adverse events and to analyze patient satisfaction based on potential explanatory variables.

DESIGN

Structured, face-to-face interview of 25% of all patients undergoing surgery during the period from January 2003 through June 2006.

SETTING

Academic university medical center.

PATIENTS

12,276 patients (5,793 men and 6,483 women) from all surgical disciplines: 7,440 patients had general anesthesia, 4,236 patients had regional anesthesia, and 600 patients had a combined general-regional anesthetic technique.

MEASUREMENTS

Occurrence of perioperative minor adverse events was assessed during the interview. Patient satisfaction was measured with a 4-point Likert scale.

MAIN RESULTS

3,652 (30%) patients reported at least one perioperative complaint and 737 (6%) patients reported multiple minor adverse events. Overall, a total of 4,475 minor adverse events were reported. Leading adverse events included postoperative nausea and vomiting (1,705 complaints), sore throat (1,228 complaints), and hoarseness (802 complaints). Patient satisfaction with anesthetic care was generally high (97% satisfied or highly satisfied). Patients were significantly more satisfied following regional than general anesthesia (P < 0.001). Patient dissatisfaction was also associated with the occurrence of at least one minor adverse event (P < 0.001) or with increasing ASA physical status (P < 0.001).

CONCLUSION

Minor events occur with a surprisingly high incidence and are significantly associated with patient dissatisfaction. Regional anesthesia is associated with fewer patient complaints and significantly higher postoperative patient satisfaction.

摘要

研究目的

评估围手术期轻微不良事件的发生率,并根据潜在的解释变量分析患者满意度。

设计

对 2003 年 1 月至 2006 年 6 月期间所有接受手术的患者的 25%进行结构化、面对面访谈。

地点

学术大学医学中心。

患者

来自所有外科学科的 12276 名患者(5793 名男性和 6483 名女性):7440 名患者接受全身麻醉,4236 名患者接受区域麻醉,600 名患者接受全身-区域混合麻醉技术。

测量

在访谈中评估围手术期轻微不良事件的发生情况。使用 4 点 Likert 量表测量患者满意度。

主要结果

3652 名(30%)患者报告至少有一次围手术期投诉,737 名(6%)患者报告有多次轻微不良事件。总共报告了 4475 次轻微不良事件。主要不良事件包括术后恶心和呕吐(1705 次投诉)、喉咙痛(1228 次投诉)和声音嘶哑(802 次投诉)。患者对麻醉护理的满意度普遍较高(97%满意或非常满意)。接受区域麻醉的患者明显比接受全身麻醉的患者更满意(P<0.001)。患者不满意也与至少一次轻微不良事件的发生(P<0.001)或 ASA 身体状况的增加(P<0.001)有关。

结论

轻微事件的发生率出人意料地高,与患者的不满显著相关。区域麻醉与较少的患者投诉相关,并显著提高术后患者满意度。

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