Shin Hsun-Chang, Kang Ting-Wei, Wu Yu Hua, Sun H Sunny, Tseng Chia-Chih Alex
Department of Anesthesiology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan.
Department of Anesthesiology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 704, Taiwan.
J Clin Monit Comput. 2018 Oct;32(5):937-944. doi: 10.1007/s10877-017-0084-1. Epub 2017 Dec 1.
This study determined whether the Simplified Postoperative Nausea and Vomiting Impact Scale (SPONVIS), could be used to predict clinically important PONV in Taiwanese. In this prospective, observational study, SPONVIS, simplified Apfel PONV Risk Scores, post-operative anti-emetic drug use, total PONV score, and 3-month recall score for PONV were recorded from Taiwanese patients who had undergone general anesthesia and surgery. With antiemetic use and 3-month recall score as validations of clinical significance, we determined whether the elements and cut-off points used in the original SPONVIS study could be used in Taiwanese patients. A total of 378 patients were included in the analysis. One hundred forty (37.1%) patients had PONV. Forty-eight patients (12.7%) had clinically important PONV (SPONVIS score ≥ 5). The odds ratios were 14.26 (CI 6.91-29.43; P < 0.001) and 4.95 (CI 2.42 to 10.11; P < 0.001), respectively, for prediction of anti-emetic drug use and 3-month recall. The SPONVIS and its construct elements were significantly related to anti-emetic drug use, 3-month recall score for PONV, total PONV score, and Apfel risk score (all P ≤ 0.005), results similar to those reported in the original Australian PONV impact score study. The SPONVIS cut-off points 3 and 5 were statistically significant predictors of anti-emetic drug use. However, a cut-off point of 3 had a higher OR (24.08) than a cut-off of 5 (14.26) for prediction of anti-emetic drug use. SPONVIS and both construct elements (the nausea and vomiting impact scores) are useful predictors of clinically important PONV in Taiwanese.
本研究旨在确定简化术后恶心呕吐影响量表（SPONVIS）是否可用于预测台湾患者临床上重要的术后恶心呕吐（PONV）。在这项前瞻性观察研究中，记录了接受全身麻醉和手术的台湾患者的SPONVIS、简化的阿佩尔PONV风险评分、术后使用止吐药情况、总PONV评分以及PONV的3个月回忆评分。以使用止吐药情况和3个月回忆评分作为临床意义的验证指标，我们确定了原始SPONVIS研究中使用的要素和截断点是否可用于台湾患者。共有378例患者纳入分析。140例（37.1%）患者发生PONV。48例（12.7%）患者发生临床上重要的PONV（SPONVIS评分≥5）。预测使用止吐药和3个月回忆情况的比值比分别为14.26（95%置信区间6.91 - 29.43；P < 0.001）和4.95（95%置信区间2.42至10.11；P < 0.001）。SPONVIS及其构成要素与使用止吐药情况、PONV的3个月回忆评分、总PONV评分以及阿佩尔风险评分均显著相关（所有P≤0.005），结果与澳大利亚原始PONV影响评分研究报道的相似。SPONVIS截断点3和5是使用止吐药的统计学显著预测指标。然而，对于预测使用止吐药情况，截断点3的比值比（24.08）高于截断点5（14.26）。SPONVIS及其两个构成要素（恶心和呕吐影响评分）是台湾患者临床上重要PONV的有用预测指标。
