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多学科脊柱会议是否改变管理方式或影响结果?

Do Multidisciplinary Spine Conferences Alter Management or Impact Outcome?

机构信息

Department of Neurosurgery, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA.

Department of Neurosurgery, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA.

出版信息

World Neurosurg. 2022 Oct;166:192-197. doi: 10.1016/j.wneu.2022.08.018. Epub 2022 Aug 10.

Abstract

BACKGROUND

Multidisciplinary spine conferences (MSCs) are a strategy for discussing diagnostic and treatment aspects of patient care. Although they are becoming more common in hospitals, literature investigating how they impact patient care and outcomes is scarce. The aim of this study is to examine the impact of MSCs on surgical management and outcomes in elective spine surgical care.

METHODS

A systematic review of the literature was conducted to evaluate the impact of MSCs on patient management and outcomes. PubMed and Cochrane databases were searched using combinations and variations of search terms "Spine Conferences," "Multidisciplinary," and "Spine Team."

RESULTS

The literature search yielded 435 articles, of which 120 were selected for full-text review. Four articles (N = 529 patients) were included. Surgical plans were discussed in 211 patients. The decision was altered to conservative treatment in 70 patients (33.17%) and a different surgical strategy in 34 patients (16.11%). The differences were significant in 2 studies (P < 0.05). A 51% reduction in 30-day complications rates was observed when MSC was implemented in patients with adult complex scoliosis. Other spinal disorders showed a 30-day complication rate between 0% and 14% after MSC.

CONCLUSIONS

To our knowledge, this is the first systematic review of outcomes of MSCs in elective spine surgery and it confirms that MSCs impact management plan and outcomes. Consistent MSCs that include surgeons and nonsurgeons have the potential to enhance communication between specialists, standardize treatments, improve patient care, and encourage teamwork. More analysis is warranted to determine if patient outcomes are improved with these measures.

摘要

背景

多学科脊柱会议(MSCs)是一种讨论患者治疗的诊断和治疗方面的策略。尽管它们在医院中越来越普遍,但关于它们如何影响患者护理和结果的文献却很少。本研究旨在探讨 MSCs 对择期脊柱手术护理中手术管理和结果的影响。

方法

系统地回顾文献,评估 MSCs 对患者管理和结果的影响。使用“Spine Conferences”、“Multidisciplinary”和“Spine Team”等搜索词的组合和变体在 PubMed 和 Cochrane 数据库中进行搜索。

结果

文献检索产生了 435 篇文章,其中有 120 篇被选为全文审查。有 4 篇文章(N=529 例患者)被纳入。在 211 例患者中讨论了手术计划。70 例患者(33.17%)决定采用保守治疗,34 例患者(16.11%)采用不同的手术策略。在 2 项研究中差异具有统计学意义(P<0.05)。当 MSCs 应用于成人复杂脊柱侧凸患者时,30 天并发症发生率降低了 51%。其他脊柱疾病在 MSCs 实施后 30 天并发症发生率在 0%至 14%之间。

结论

据我们所知,这是首个关于 MSCs 在择期脊柱手术中结果的系统评价,它证实了 MSCs 影响管理计划和结果。包括外科医生和非外科医生的一致 MSCs 有可能增强专家之间的沟通,使治疗标准化,改善患者护理,并鼓励团队合作。需要进一步分析以确定这些措施是否改善了患者的预后。

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