Rappold Daniela, Stättner Stefan, Nöhammer Elisabeth
Department of General, Visceral and Vascular Surgery, Oberösterreichische Gesundheitsholding, 4840 Vöcklabruck, Austria.
Department of Public Health, Health Services Research & HTA, UMIT TIROL-Private University for Health Sciences and Health Technology, 6060 Hall in Tirol, Austria.
Healthcare (Basel). 2024 Mar 11;12(6):629. doi: 10.3390/healthcare12060629.
ERAS (Enhanced Recovery after Surgery) is an evidence-based multidisciplinary approach focusing on optimizing outcomes after surgery through structured clinical pathways. This study aimed to assess patient-reported outcome and experience measures (PROM/PREM), which are not routinely assessed after liver surgery within an ERAS protocol.
Routine outcome parameters were extracted from clinical documentation. Using qualitative content analysis, PROM and PREM were retrospectively identified in 13 case records. In a prospective survey of 10 participants, PROM was assessed at three timepoints using the EQ-5D-5L questionnaire. PREM were collected at discharge.
The following PROM categories occurred in the retrospective content analysis: (84.6%), (76.9%), (69.2%), (69.2%), and (61.5%). The categories of (92.0%) and , , (69.0%) emerged as PREM. Descriptive changes in health state were shown for all EQ-5D-5L dimensions and timepoints. At discharge, , , , and tended to be worse, whereas decreased gradually from preoperatively to the 4 week follow-up. There was high satisfaction with interprofessional care services and experienced cooperation between professionals.
PROM and PREM are helpful to incorporate patients' perspectives after liver surgery within an ERAS pathway and should be collected routinely in clinical practice.
加速康复外科（ERAS，Enhanced Recovery after Surgery）是一种基于证据的多学科方法，专注于通过结构化临床路径优化手术后的结局。本研究旨在评估患者报告的结局和体验指标（PROM/PREM），这些指标在ERAS方案下的肝脏手术后并非常规评估项目。
从临床记录中提取常规结局参数。采用定性内容分析法，对13份病例记录进行回顾性分析以确定PROM和PREM。在一项针对10名参与者的前瞻性调查中，使用EQ-5D-5L问卷在三个时间点评估PROM。在出院时收集PREM。
回顾性内容分析中出现的PROM类别如下：（84.6%）、（76.9%）、（69.2%）、（69.2%）和（61.5%）。PREM出现的类别为（92.0%）以及、、（69.0%）。所有EQ-5D-5L维度和时间点均显示出健康状态的描述性变化。出院时，、、、往往较差，而从术前到术后4周随访逐渐下降。对跨专业护理服务满意度高，且体验到专业人员之间的合作。
PROM和PREM有助于在ERAS路径中纳入肝脏手术后患者的观点，应在临床实践中常规收集。
