Petridis Alexandria Paige, Koh Cherry, Solomon Michael, Karunaratne Sascha, Alexander Kate, Hirst Nicholas, Pillinger Neil, Denehy Linda, Riedel Bernhard, Gillis Chelsia, Carey Sharon, McBride Kate, White Kate, Dhillon Haryana, Campbell Patrick, Reeves Jack, Biswas Raaj Kishore, Steffens Daniel
Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney 2050, Australia.
Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney 2050, Australia.
Cancers (Basel). 2025 Mar 3;17(5):861. doi: 10.3390/cancers17050861.
BACKGROUND/OBJECTIVE: Despite surgery being the primary curative treatment for cancer, patients with compromised preoperative physical, nutritional, and psychological status are often at a higher risk for complications. While various screening tools exist to assess physical, nutritional, and psychological status, there is currently no standardised self-reporting tool, or established cut-off points for comprehensive risk assessment. This study aims to develop, validate, and implement an online self-reporting preoperative screening tool that identifies modifiable risk factors in cancer surgery patients.
This mixed-methods study consists of three distinct stages: (1) Development-(i) a scoping review to identify available physical, nutritional, and psychological screening tools; (ii) a Delphi study to gain consensus on the use of available screening tools; and (iii) a development of the online screening tool to determine patients at high risk of postoperative complications. (2) Testing-a prospective cohort study determining the correlation between at-risk patients and postoperative complications. (3) Implementation-the formulation of an implementation policy document considering feasibility.
The timely identification of high-risk patients, based on their preoperative physical, nutritional, and psychological statuses, would enable referral to targeted interventions. The implementation of a preoperative online screening tool would streamline this identification process while minimising unwarranted variation in preoperative treatment optimisation. This systematic approach would not only support high-risk patients but also allow for more efficient provision of surgery to low-risk patients through effective risk stratification.
背景/目的：尽管手术是癌症的主要治愈性治疗方法，但术前身体、营养和心理状态受损的患者往往并发症风险更高。虽然存在各种筛查工具来评估身体、营养和心理状态，但目前尚无标准化的自我报告工具或用于综合风险评估的既定临界点。本研究旨在开发、验证并实施一种在线自我报告术前筛查工具，以识别癌症手术患者中可改变的风险因素。
这项混合方法研究包括三个不同阶段：（1）开发——（i）进行范围审查以识别可用的身体、营养和心理筛查工具；（ii）开展德尔菲研究以就可用筛查工具的使用达成共识；（iii）开发在线筛查工具以确定术后并发症高风险患者。（2）测试——一项前瞻性队列研究，确定高危患者与术后并发症之间的相关性。（3）实施——制定一份考虑可行性的实施政策文件。
根据患者术前的身体、营养和心理状态及时识别高危患者，将有助于转介至有针对性的干预措施。术前在线筛查工具的实施将简化这一识别过程，同时最大限度减少术前治疗优化中不必要的差异。这种系统方法不仅将支持高危患者，还将通过有效的风险分层，使低风险患者能够更高效地接受手术。
