Department of Anesthesia, St. Michael's Hospital, Toronto, ON, Canada.
Department of Anesthesia and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Anaesthesia. 2020 Jan;75 Suppl 1:e151-e157. doi: 10.1111/anae.14903.
The traditional approach for measuring outcomes after surgery involves ascertaining whether a patient survived surgery while avoiding major complications. This approach does not capture the full spectrum of events that are meaningful to patients, especially because mortality risks after elective surgery are relatively low, and different complication types vary considerably with respect to their impact on postoperative recovery. This review discusses the application, advantages, disadvantages and select examples of patient-centred outcomes in peri-operative medicine. When applied appropriately, these outcomes complement traditional clinical outcomes, identify important changes in postoperative function that impact patients without discernible complications and ensure that the definition of success after surgery is more meaningful to all relevant stakeholders.
传统的手术效果评估方法包括确定患者是否在手术中存活且未发生严重并发症。但这种方法无法全面反映对患者有意义的各种事件,尤其是因为择期手术后的死亡风险相对较低,不同类型的并发症对术后恢复的影响也大不相同。本文讨论了围手术期医学中患者为中心的结局指标的应用、优势、劣势和一些实例。恰当应用这些指标可以补充传统的临床结局指标,发现对患者有重要影响但无明显并发症的术后功能变化,并确保手术成功的定义对所有相关利益方更有意义。