Fraile Olivero Carlos Alfredo, Jarabo Sarceda José Ramón, Fernández Martín Elena, Alen Villamayor Verónica, Calatayud Gastardi Joaquín, Gómez Martínez Ana María, Santos Passio, Arribas Manzanal Pedro Daniel, Cerdán Santacruz Carlos, Hernando Trancho Florentino
Thoracic Surgery Department, Hospital Clínico San Carlos, 28040 Madrid, Spain.
Physical Medicine and Rehabilitation Department, Hospital Clínico San Carlos, 28040 Madrid, Spain.
J Clin Med. 2023 Oct 26;12(21):6774. doi: 10.3390/jcm12216774.
Postoperative pulmonary complications (PPCs) increase the hospital length of stay (LOS) and the cost of healthcare associated with surgical procedures. Strategies to reduce PPCs begin before surgery and continue in the postoperative period. Fissios App© is a smartphone application that contains perioperative medical advice and a structured respiratory physiotherapy program. The objective was to implement the use of this app in a group of patients scheduled for a thoracic surgical procedure and determine its efficacy in reducing PPCs. This was a quasi-experimental study in which all patients attended a face-to-face respiratory physiotherapy program, and the intervention group used Fissios App© as a complement. We prospectively recorded the postoperative evolution of both groups, analyzed the categorical differences and quantitative variables, and created a binary logistic regression model. We recruited 393 patients (131 intervention and 262 control). The intervention group had a lower incidence of PPCs (12.2% versus 24% in the control group, = 0.006), a shorter LOS (a median of 3 days (IQR = 2-5) versus 4 days (IQR = 3-6, = 0.001) in the control group), and a reduction in the risk of developing PPCs by 63.5% (OR: 0.365, 95% CI: 0.17-0.78). The use of Fissios App© improved the clinical outcomes after surgery and reduced the probability of developing PPCs.
术后肺部并发症(PPCs)会延长住院时间(LOS),增加与外科手术相关的医疗费用。降低PPCs的策略在手术前就开始,并持续到术后阶段。Fissios App©是一款智能手机应用程序,其中包含围手术期医疗建议和结构化的呼吸物理治疗方案。目的是在一组计划进行胸外科手术的患者中应用该应用程序,并确定其在降低PPCs方面的疗效。这是一项准实验研究,所有患者都参加了面对面的呼吸物理治疗方案,干预组将Fissios App©作为补充使用。我们前瞻性地记录了两组患者的术后病情发展,分析了分类差异和定量变量,并创建了二元逻辑回归模型。我们招募了393名患者(131名干预组和262名对照组)。干预组的PPCs发生率较低(12.2%,而对照组为24%,P = 0.006),住院时间较短(中位数为3天(四分位间距 = 2 - 5),而对照组为4天(四分位间距 = 3 - 6,P = 0.001)),发生PPCs的风险降低了63.5%(比值比:0.365,95%置信区间:0.17 - 0.78)。使用Fissios App©改善了手术后的临床结局,并降低了发生PPCs的概率。