移动健康随访下术后14天内恢复情况及医疗接触中的性别差异：一项随机对照试验的二次分析
Sex Similarities in Postoperative Recovery and Health Care Contacts Within 14 Days With mHealth Follow-Up: Secondary Analysis of a Randomized Controlled Trial.
作者信息
Jaensson Maria, Dahlberg Karuna, Nilsson Ulrica
机构信息
School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
出版信息
JMIR Perioper Med. 2018 Mar 26;1(1):e2. doi: 10.2196/periop.9874.
BACKGROUND
Previous studies have shown that women tend to have a poorer postanesthesia recovery than men. Our research group has developed a mobile phone app called Recovery Assessment by Phone Points (RAPP) that includes the Swedish Web version of the Quality of Recovery (SwQoR) questionnaire to monitor and assess postoperative recovery.
OBJECTIVE
The aim of this study was to investigate sex differences in postoperative recovery and the number of health care contacts within 14 postoperative days in a cohort of day-surgery patients using RAPP.
METHODS
This study was a secondary analysis from a single-blind randomized controlled trial. Therefore, we did not calculate an a priori sample size regarding sex differences. We conducted the study at 4 day-surgery settings in Sweden from October 2015 to July 2016. Included were 494 patients (220 male and 274 female participants) undergoing day surgery. The patients self-assessed their postoperative recovery for 14 postoperative days using the RAPP.
RESULTS
There were no significant sex differences in postoperative recovery or the number of health care contacts. Subgroup analysis showed that women younger than 45 years reported significantly higher global scores in the SwQoR questionnaire (hence a poorer recovery) on postoperative days 1 to 10 than did women who were 45 years of age or older (P=.001 to P=.008). Men younger than 45 years reported significantly higher global scores on postoperative days 2 to 6 than did men 45 years of age or older (P=.001 to P=.006). Sex differences in postoperative recovery were not significant between the age groups.
CONCLUSIONS
This study found sex similarities in postoperative recovery and the number of health care contacts. However, subgroup analysis showed that age might be an independent factor for poorer recovery in both women and men. This knowledge can be used when informing patients what to expect after discharge.
TRIAL REGISTRATION
ClinicalTrials.gov NCT02492191; https://clinicaltrials.gov/ct2/show/NCT02492191 (Archived by WebCite at http://www.webcitation.org/6y2UtMbvz).
背景
先前的研究表明，女性麻醉后恢复情况往往比男性差。我们的研究小组开发了一款名为“通过电话评分进行恢复评估”（RAPP）的手机应用程序，其中包含瑞典语网络版的恢复质量（SwQoR）问卷，用于监测和评估术后恢复情况。
目的
本研究旨在调查使用RAPP的日间手术患者队列术后恢复情况的性别差异以及术后14天内的医疗保健接触次数。
方法
本研究是一项单盲随机对照试验的二次分析。因此，我们未计算关于性别差异的先验样本量。我们于2015年10月至2016年7月在瑞典的4个日间手术机构开展了该研究。纳入了494例行日间手术的患者（220名男性和274名女性参与者）。患者使用RAPP对术后14天的恢复情况进行自我评估。
结果
术后恢复情况或医疗保健接触次数方面不存在显著的性别差异。亚组分析显示，45岁以下女性在术后第1至10天的SwQoR问卷总体评分显著高于45岁及以上女性（因此恢复较差）（P = 0.001至P = 0.008）。45岁以下男性在术后第2至6天的总体评分显著高于45岁及以上男性（P = 0.001至P = 0.006）。各年龄组之间术后恢复情况的性别差异不显著。
结论
本研究发现术后恢复情况和医疗保健接触次数方面存在性别相似性。然而，亚组分析表明年龄可能是女性和男性恢复较差的一个独立因素。在告知患者出院后预期情况时可利用这一知识。
试验注册
ClinicalTrials.gov NCT02492191；https://clinicaltrials.gov/ct2/show/NCT02492191（由WebCite存档于http://www.webcitation.org/6y2UtMbvz）
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