Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Surg Today. 2011 Jun;41(6):787-90. doi: 10.1007/s00595-010-4483-x. Epub 2011 May 28.
To evaluate the efficacy of the current clinical pathway for pulmonary resections.
This study examined variances from expected clinical pathway outcomes for pulmonary resections performed between 2005 and 2009. Data on a total of 383 patients were retrospectively analyzed.
The median length of hospital stay (LOS) using the clinical pathway was 12 days (range: 1-188 days); the mean LOS was 15.5 days. The cost per day with use of the clinical pathway was 102 726 yen. Poor control of pain from intercostal neuralgia was the most frequently observed variance from expected outcomes. It affected 119 of 168 electronic clinical pathway patients (70.8%). The clinical pathway was terminated in 3.9% of patients (15/383) due to serious or life-threatening complications.
This study showed the single institutional experience of the clinical pathway for pulmonary resections. These findings indicate a need to revise certain aspects of the pathway, based on data from our analysis of variances.
评估当前肺切除术临床路径的疗效。
本研究分析了 2005 年至 2009 年间实施的肺切除术与预期临床路径结果的差异。对总共 383 例患者的数据进行了回顾性分析。
使用临床路径的中位住院时间（LOS）为 12 天（范围：1-188 天）；平均 LOS 为 15.5 天。使用临床路径的每天费用为 102726 日元。肋间神经痛导致的疼痛控制不佳是最常见的不符合预期结果的情况，在 168 名电子临床路径患者中影响了 119 名（70.8%）。由于严重或危及生命的并发症，有 3.9%的患者（383 例中的 15 例）终止了临床路径。
本研究展示了肺切除术临床路径的单机构经验。这些发现表明，需要根据我们对差异分析的数据来修订路径的某些方面。
