Mousa Albeir Y, Broce Mike, Davis Elaine, McKee Barbara, Yacoub Michael
Department of Surgery, Robert C. Byrd Health Sciences Center/West Virginia University, Charleston Area Medical Center, Vascular Center of Excellence, Charleston, WVa.
Center for Health Services and Outcomes Research, Charleston Area Medical Center Health Education and Research Institute, Charleston, WVa.
J Vasc Surg. 2017 Dec;66(6):1902-1908. doi: 10.1016/j.jvs.2017.07.063.
It is intuitive that postdischarge surgical complications are associated with increased patient dissatisfaction, and are directly associated with an increase in medical expenditures. It is also easy to make the connection that many post-hospital discharge surgical complications, including surgical site infections (SSIs), could be influenced or exacerbated by patient comorbidities. The authors of a recent study reported that female gender, obesity, diabetes, smoking, hypertension, coronary artery disease, critical limb ischemia, chronic obstructive pulmonary disease, dyspnea, and neurologic disease were significant predictors of SSIs after vascular reconstruction was performed. The main concern for optimal patient care, especially in geographically isolated areas of West Virginia, is to have early, expeditious, and prompt diagnosis of complications and SSI. This adjunct to existing approaches could lead to improved outcomes and patient satisfaction, minimizing third-party interventions and decreasing the total cost of care. It seems reasonable to believe that monitoring using telehealth technology and managing the general health care of patients after a hospital vascular intervention will improve overall health and reduce 30-day readmissions and SSIs.
直观地说,出院后手术并发症与患者满意度降低相关,并且直接与医疗费用增加有关。同样容易建立这样的联系,即许多出院后手术并发症,包括手术部位感染(SSI),可能会受到患者合并症的影响或加剧。最近一项研究的作者报告称,女性、肥胖、糖尿病、吸烟、高血压、冠状动脉疾病、严重肢体缺血、慢性阻塞性肺疾病、呼吸困难和神经系统疾病是血管重建术后手术部位感染的重要预测因素。对于优化患者护理,尤其是在西弗吉尼亚州地理上偏远的地区,主要关注点在于对并发症和手术部位感染进行早期、迅速且及时的诊断。这种对现有方法的辅助手段可能会改善治疗结果和患者满意度,减少第三方干预并降低总体护理成本。有理由相信,使用远程医疗技术进行监测并在医院血管介入后管理患者的总体医疗保健将改善整体健康状况,并减少30天再入院率和手术部位感染。