Helsten Daniel L, Ben Abdallah Arbi, Avidan Michael S, Wildes Troy S, Winter Anke, McKinnon Sherry, Bollini Mara, Candelario Penny, Burnside Beth A, Sharma Anshuman
From the Department of Anesthesiology, Institute of Quality Improvement, Research and Informatics (INQUIRI), Washington University School of Medicine, St. Louis, Missouri (D.L.H., A.B.A., M.S.A., T.S.W., S.M., M.B., P.C., A.S.); Department of Surgery, Washington University School of Medicine, St. Louis, Missouri (A.W.); and Wright State University and Premier Health Clinical Trials Research Alliance, Miami Valley Hospital, Dayton, Ohio (B.A.B.).
Anesthesiology. 2016 Sep;125(3):495-504. doi: 10.1097/ALN.0000000000001217.
The impact of surgery on health is only appreciated long after hospital discharge. Furthermore, patients' perceptions of postoperative health are not routinely ascertained. The authors instituted the Systematic Assessment and Targeted Improvement of Services Following Yearlong Surgical Outcomes Surveys (SATISFY-SOS) registry to evaluate patients' postoperative health based on patient-reported outcomes (PROs).
This article describes the methods of establishing the SATISFY-SOS registry from an unselected surgical population, combining perioperative PROs with information from electronic medical records. Patients enrolled during their preoperative visit were surveyed at enrollment, 30 days, and 1-yr postoperatively. Information on PROs, including quality of life, return to work, pain, functional status, medical complications, and cognition, was obtained from online, mail, or telephone surveys.
Using structured query language, 44,081 patients were identified in the electronic medical records as having visited the Center for Preoperative Assessment and Planning for preoperative assessment between July 16, 2012, and June 15, 2014, and 20,719 patients (47%) consented to participate in SATISFY-SOS. Baseline characteristics and health status were similar between enrolled and not enrolled patients. The response rate for the 30-day survey was 62% (8% e-mail, 73% mail, and 19% telephone) and for the 1-yr survey was 71% (13% e-mail, 78% mail, and 8% telephone).
SATISFY-SOS demonstrates the feasibility of establishing a PRO registry reflective of a busy preoperative assessment center population, without disrupting clinical workflow. Our experience suggests that patient engagement, including informed consent and multiple survey modalities, enhances PROs collection from a large cohort of unselected surgical patients. Initiatives like SATISFY-SOS could promote quality improvement, enable efficient perioperative research, and facilitate outcomes that matter to surgical patients.
手术对健康的影响在出院后很长时间才会显现出来。此外，患者对术后健康的认知情况通常并未得到评估。作者设立了“长期手术结果调查后服务的系统评估与针对性改善”（SATISFY-SOS）登记处，以基于患者报告结局（PRO）评估患者的术后健康状况。
本文描述了从不特定手术人群中建立SATISFY-SOS登记处的方法，将围手术期PRO与电子病历信息相结合。术前就诊时登记的患者在登记时、术后30天和术后1年接受调查。通过在线、邮寄或电话调查获取有关PRO的信息，包括生活质量、恢复工作情况、疼痛、功能状态、医疗并发症和认知情况。
使用结构化查询语言，在电子病历中识别出44,081名患者在2012年7月16日至2014年6月15日期间到术前评估与规划中心进行术前评估，其中20,719名患者（47%）同意参与SATISFY-SOS。登记患者和未登记患者的基线特征和健康状况相似。30天调查的回复率为62%（电子邮件8%，邮寄73%，电话19%），1年调查的回复率为71%（电子邮件13%，邮寄78%，电话8%）。
SATISFY-SOS证明了建立一个反映繁忙术前评估中心人群的PRO登记处的可行性，且不会扰乱临床工作流程。我们的经验表明，患者参与，包括知情同意和多种调查方式，可提高从不特定手术患者大群体中收集PRO的效率。像SATISFY-SOS这样的举措可以促进质量改进，实现高效的围手术期研究，并推动对手术患者重要结局的实现。
