Department of Surgery, Ringgold ID: 6684Oregon Health and Science University, OR, USA.
Am Surg. 2020 Nov;86(11):1441-1444. doi: 10.1177/0003134820960047. Epub 2020 Nov 6.
A 55-year-old man undergoes emergent exploratory laparotomy and splenectomy following a motorcycle collision. Following surgery, he is found to have a traumatic brain injury requiring decompressive craniectomy and intracranial pressure monitoring. The patient then continues to have complications throughout his hospital course. Using the American College of Surgeons Trauma Quality Improvement Program guidelines, the surgical team has early and ongoing primary palliative care discussions to foster communication and determine goals of care for the patient. As the patient deteriorates, the surgical team continues meeting with the patient's surrogate decision makers to discuss the best case and worst case scenarios regarding the patient's prognosis and expected quality of life.
一位 55 岁男性在遭遇摩托车事故后，接受了紧急剖腹探查和脾切除术。手术后，他被发现患有创伤性脑损伤，需要进行去骨瓣减压术和颅内压监测。此后，患者在整个住院过程中一直存在并发症。该外科手术团队根据美国外科医师学院创伤质量改进计划指南，进行了早期和持续的初级姑息治疗讨论，以促进沟通并确定患者的治疗目标。随着患者病情恶化，外科手术团队继续与患者的代理人决策者会面，讨论患者预后和预期生活质量的最佳和最差情况。
