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用于预测外科医生肌肉骨骼损伤的计算器:一种机器学习方法。

A calculator for musculoskeletal injuries prediction in surgeons: a machine learning approach.

机构信息

General and Gastrointestinal Surgery Department, University General Hospital of Elche, Miguel Hernández University, 11 Almazara Street, 03203, Elche, Alicante, Spain.

Physiotherapy, Pathology and Surgery Department, Translational Research Center, INTRAFIS Research Group, Miguel Hernández University of Elche, Avenue of the University of Elx, S/N, 03202, Elche, Alicante, Spain.

出版信息

Surg Endosc. 2024 Nov;38(11):6577-6585. doi: 10.1007/s00464-024-11237-4. Epub 2024 Sep 16.

Abstract

BACKGROUND

Surgical specialists experience significant musculoskeletal strain as a consequence of their profession, a domain within the healthcare system often recognized for the pronounced impact of such issues. The aim of this study is to calculate the risk of presenting musculoskeletal injuries in surgeons after surgical practice.

METHODS

Cross-sectional study carried out using an online form (12/2021-03/2022) aimed at members of the Spanish Association of Surgeons. Demographic variables on physical and professional activity were recorded, as well as musculoskeletal pain (MSP) associated with surgical activity. Univariate and multivariate analysis were conducted to identify risk factors associated with the development of MSP based on personalized surgical activity. To achieve this, a risk algorithm was computed and an online machine learning calculator was created to predict them. Physiotherapeutic recommendations were generated to address and alleviate each MSP.

RESULTS

A total of 651 surgeons (112 trainees, 539 specialists). 90.6% reported MSP related to surgical practice, 60% needed any therapeutic measure and 11.7% required a medical leave. In the long term, MSP was most common in the cervical and lumbar regions (52.4, 58.5%, respectively). Statistically significant risk factors (OR CI 95%) were for trunk pain, long interventions without breaks (3.02, 1.65-5.54). Obesity, indicated by BMI, to lumbar pain (4.36, 1.84-12.1), while an inappropriate laparoscopic screen location was associated with cervical and trunk pain (1.95, 1.28-2.98 and 2.16, 1.37-3.44, respectively). A predictive model and an online calculator were developed to assess MSP risk. Furthermore, a need for enhanced ergonomics training was identified by 89.6% of surgeons.

CONCLUSIONS

The prevalence of MSP among surgeons is a prevalent but often overlooked health concern. Implementing a risk calculator could enable tailored prevention strategies, addressing modifiable factors like ergonomics.

摘要

背景

由于职业原因,外科专家会经历显著的肌肉骨骼劳损,而医疗保健系统中通常会认识到这类问题的明显影响。本研究旨在计算外科医生在手术后出现肌肉骨骼损伤的风险。

方法

使用在线表格(2021 年 12 月至 2022 年 3 月)进行横断面研究,调查对象为西班牙外科医生协会成员。记录了与身体和职业活动相关的人口统计学变量,以及与手术活动相关的肌肉骨骼疼痛(MSP)。进行单变量和多变量分析,以根据个性化手术活动确定与 MSP 发展相关的危险因素。为此,计算了风险算法,并创建了一个在线机器学习计算器来预测这些危险因素。生成了物理治疗建议,以解决和缓解每个 MSP。

结果

共有 651 名外科医生(112 名受训者,539 名专家)。90.6%的人报告称与手术实践相关的 MSP,60%的人需要任何治疗措施,11.7%的人需要请病假。从长期来看,MSP 在颈椎和腰椎区域最为常见(分别为 52.4%和 58.5%)。统计学上显著的危险因素(OR CI 95%)是躯干疼痛、长时间无休息的干预(3.02,1.65-5.54)。BMI 表示的肥胖与腰椎疼痛相关(4.36,1.84-12.1),而不合适的腹腔镜屏幕位置与颈椎和躯干疼痛相关(分别为 1.95,1.28-2.98 和 2.16,1.37-3.44)。开发了一个预测模型和一个在线计算器来评估 MSP 风险。此外,89.6%的外科医生认为需要加强人体工程学培训。

结论

外科医生中 MSP 的患病率是一个普遍存在但经常被忽视的健康问题。实施风险计算器可以使针对性预防策略成为可能,解决可改变的因素,如人体工程学。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af92/11525384/aad8e137aec6/464_2024_11237_Fig1_HTML.jpg

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