出院时患者自述症状与妇科手术后并发症风险
Patient-reported symptoms at discharge and risk of complications after gynecologic surgery.
机构信息
Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, Houston, Texas, USA.
出版信息
Int J Gynecol Cancer. 2023 Feb 6;33(2):271-277. doi: 10.1136/ijgc-2022-004016.
OBJECTIVE
Current gaps in knowledge limit clinicians from fully implementing patient-reported outcomes in routine post-operative care.
METHODS
This prospective study assessed symptoms via the gynecologic module of the MD Anderson Symptom Inventory (MDASI-PeriOp-GYN) in patients who underwent open laparotomy.
RESULTS
At discharge, patient-reported moderate to severe (≥4 on a 0-10 scale) abdominal bloating or abdominal cramping, combined with length of stay of ≥4 days, were found to be associated with a higher risk of 30-day post-operative grade II-IV complications by the Clavien-Dindo system (all p values <0.01). Also, length of stay of ≥4 days and moderate to severe urinary urgency at discharge were found to be associated with the need for re-admission (all p values <0.01).
CONCLUSION
This study defined the clinically meaningful symptoms that related to the risk of developing important complications after discharge from major open gynecological surgery.These findings support the integration of assessment of patient-reported outcomes into patient-centered post-operative care.
目的
目前知识的欠缺限制了临床医生在常规术后护理中充分应用患者报告的结局。
方法
本前瞻性研究通过 MD 安德森症状指数（MDASI-PeriOp-GYN）的妇科模块评估了接受开腹手术患者的症状。
结果
在出院时，发现患者报告的中重度（≥4 分，0-10 分制）腹胀或腹痛，同时伴有≥4 天的住院时间，与 Clavien-Dindo 系统术后 30 天 II-IV 级并发症的发生风险较高相关（所有 p 值均<0.01）。此外，出院时≥4 天的住院时间和中重度尿急与再次入院相关（所有 p 值均<0.01）。
结论
本研究确定了与主要开腹妇科手术后出院后发生重要并发症风险相关的有临床意义的症状。这些发现支持将患者报告的结局评估纳入以患者为中心的术后护理中。
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