心脏手术对患者报告结局的一年影响：一项前瞻性队列研究。
Effect of Cardiac Surgery on One-Year Patient-Reported Outcomes: A Prospective Cohort Study.
机构信息
Department of Surgery, University of Virginia, Charlottesville, Virginia.
Surgical Therapeutic Advancement Center, University of Virginia, Charlottesville, Virginia.
出版信息
Ann Thorac Surg. 2021 Nov;112(5):1410-1416. doi: 10.1016/j.athoracsur.2020.09.061. Epub 2020 Dec 10.
BACKGROUND
Current cardiac surgery risk algorithms and quality measures focus on perioperative outcomes. However, delivering high-value, patient-centered cardiac care will require a better understanding of long-term patient-reported quality of life after surgery. Our objective was to prospectively assess the effect of cardiac surgery on long-term patient-reported outcomes.
METHODS
Patients undergoing cardiac surgery at an academic medical center (2016 to 2017) were eligible for enrollment. Patient-reported outcomes were measured using the National Institutes of Health Patient-Reported Outcomes Measurement Information System preoperatively and 1 year postoperatively across five domains: mental health, physical health, physical functioning, social satisfaction, and applied cognition. Baseline data and perioperative outcomes were obtained from The Society of Thoracic Surgeons Database. The effect of cardiac surgery on long-term patient-reported quality of life was assessed.
RESULTS
Ninety-eight patients were enrolled and underwent cardiac surgery, with 92.9% (91 of 98) successful follow-up. The most common operation was coronary artery bypass graft surgery at 63.3% (62 of 98), with 60.2% (59 of 98) undergoing an elective operation. One-year all-cause mortality was 5.1% (5 of 98). Rate of major morbidity was 11.2% (11 of 98). Cardiac surgery significantly improved patient-reported outcomes at 1 year across four domains: mental health (preoperative 47.3 ± 7.7 vs postoperative 51.1 ± 8.9, P < .001), physical health (41.2 ± 8.2 vs 46.3 ± 9.3, P < .001), physical functioning (39.8 ± 8.6 vs 44.8 ± 8.5, P < .001), and social satisfaction (46.8 ± 10.9 vs 50.7 ± 10.8, P = .023). Hospital discharge to a facility did not affect 1-year patient-reported outcomes.
CONCLUSIONS
Cardiac surgery improves long-term patient-reported quality of life. Mental, physical, and social well-being scores were significantly higher 1 year postoperatively. Data collection with the National Institutes of Health Patient-Reported Outcomes Measurement Information System provides meaningful, quantifiable results that may improve delivery of patient-centered care.
背景
目前的心脏外科风险算法和质量指标主要关注围手术期结果。然而，提供高价值、以患者为中心的心脏护理将需要更好地了解手术后患者长期的报告的生活质量。我们的目的是前瞻性评估心脏手术对长期患者报告结果的影响。
方法
在一家学术医疗中心（2016 年至 2017 年）接受心脏手术的患者有资格入组。使用美国国立卫生研究院患者报告测量信息系统（National Institutes of Health Patient-Reported Outcomes Measurement Information System）在五个领域测量患者报告的结果：心理健康、身体健康、身体机能、社会满意度和应用认知。从胸外科医生协会数据库（The Society of Thoracic Surgeons Database）获得基线数据和围手术期结果。评估心脏手术对长期患者报告的生活质量的影响。
结果
98 名患者入组并接受了心脏手术，92.9%（98 名中的 91 名）成功完成了随访。最常见的手术是冠状动脉旁路移植术，占 63.3%（98 名中的 62 名），其中 60.2%（98 名中的 59 名）为择期手术。1 年全因死亡率为 5.1%（98 名中的 5 名）。主要发病率的发生率为 11.2%（98 名中的 11 名）。心脏手术后，患者在四个领域的报告结果在 1 年内显著改善：心理健康（术前 47.3 ± 7.7 与术后 51.1 ± 8.9，P <.001）、身体健康（41.2 ± 8.2 与 46.3 ± 9.3，P <.001）、身体机能（39.8 ± 8.6 与 44.8 ± 8.5，P <.001）和社会满意度（46.8 ± 10.9 与 50.7 ± 10.8，P =.023）。出院到医疗机构并不影响 1 年的患者报告结果。
结论
心脏手术可改善长期患者报告的生活质量。术后 1 年，心理健康、身体和社会幸福感评分显著提高。使用美国国立卫生研究院患者报告测量信息系统（National Institutes of Health Patient-Reported Outcomes Measurement Information System）进行数据收集可提供有意义的、可量化的结果，从而可能改善以患者为中心的护理服务。
Zotero 插件