Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
World Neurosurg. 2020 Sep;141:e888-e893. doi: 10.1016/j.wneu.2020.06.082. Epub 2020 Jun 17.
The analysis of perioperative electronic patient portal (EPP) communication may provide risk stratification and insight for complication prevention in patients with affective disorders (ADs). We aimed to understand how patterns of EPP communication in patients with AD relate to preoperative narcotic use, surgical outcomes, and readmission rates.
The records of adult patients who underwent elective spinal surgery between January 2010 and August 2017 at a single institution were retrospectively reviewed for analysis. Primary outcomes included preoperative narcotic use, the number of perioperative EPP messages sent, rates of perioperative complications, hospital length of stay, emergency department (ED) visits within 6 weeks, and readmissions within 30 days after surgery.
A total of 1199 patients were included in the analysis. Patients with an AD were more likely to take narcotics before surgery (51.69% vs. 41%, P < 0.001) and to have active EPP accounts (75.36% vs. 69.75%, P = 0.014) compared with controls. They were also more likely to send postoperative messages (38.89% vs. 32.75%, P = 0.030) and tended to send more messages (0.67 vs. 0.48, P = 0.034). The AD group had higher rates of postoperative complications (8.21% vs. 3.98%, P = 0.001), ED visits (4.99% vs. 2.43%, P = 0.009), and readmissions postoperatively (2.49% vs. 1.38%, P = 0.049).
AD patients have specific patterns of perioperative EPP communication. They are at a higher risk of postoperative complications. Addressing these concerns early may prevent more serious morbidity and avoid unnecessary ED visits and readmissions, thus reducing costs and improving patient care.
分析围手术期电子患者门户（EPP）通信情况，可能为情感障碍（AD）患者的并发症预防提供风险分层和深入了解。我们旨在了解 AD 患者 EPP 通信模式与术前使用麻醉药物、手术结果和再入院率之间的关系。
回顾性分析了 2010 年 1 月至 2017 年 8 月在一家机构接受择期脊柱手术的成年患者的记录，进行分析。主要结果包括术前使用麻醉药物、围手术期 EPP 消息发送数量、围手术期并发症发生率、住院时间、术后 6 周内急诊就诊率和术后 30 天内再入院率。
共纳入 1199 例患者进行分析。与对照组相比，AD 患者术前更有可能使用麻醉药物（51.69% vs. 41%，P<0.001），且更有可能拥有活跃的 EPP 账户（75.36% vs. 69.75%，P=0.014）。他们也更有可能发送术后消息（38.89% vs. 32.75%，P=0.030），且倾向于发送更多消息（0.67 条 vs. 0.48 条，P=0.034）。AD 组术后并发症发生率（8.21% vs. 3.98%，P=0.001）、急诊就诊率（4.99% vs. 2.43%，P=0.009）和术后再入院率（2.49% vs. 1.38%，P=0.049）更高。
AD 患者围手术期 EPP 通信模式具有一定特点。他们术后并发症风险更高。早期解决这些问题可以预防更严重的发病率，避免不必要的急诊就诊和再入院，从而降低成本并改善患者护理。
