Temple P C, Travis B, Sachs L, Strasser S, Choban P, Flancbaum L
Ohio State University Managed Health Care Systems, Inc., Columbus, USA.
J Am Coll Surg. 1995 Jul;181(1):17-25.
Recent changes in health care delivery and financing have prompted interest in medical outcomes research. This study was performed to assess the effect of general surgical procedures on the health status of patients over time.
The functional health status of patients undergoing elective surgical procedures was measured preoperatively, in the immediate postoperative period, and three and six months after surgery. Complete data were collected for 82 patients presenting to the general surgery service at the Ohio State University Medical Center for symptoms related to gallbladder disease (21), hemorrhoids (10), inguinal and incisional hernias (37), and clinically severe obesity (14). The Short Form-36 health status questionnaire was administered before the surgical procedure, at the first postoperative visit, and by telephone three months and six months following surgery. Hospital records were reviewed following the procedures, and preoperative anesthesiologist's risk status, American Society of Anesthesiologists scores, and complications were noted. Patient satisfaction was assessed using a questionnaire developed by Ohio State University.
For all four elective procedures, a significant improvement in health status was demonstrated when preoperative function was compared to measurements three and six months postoperatively. Improvement was significant in all eight categories assessed, encompassing physical, social, mental, emotional, and general health, and pain relief. Dramatic improvement was reported by patients undergoing Roux-en-Y gastric bypass for clinically severe obesity.
The Short Form-36 health status questionnaire proved to be a useful tool in assessing patient outcomes following elective surgical procedures. The general health status assessment will be especially useful for documenting the effectiveness of routine and innovative therapies.
近期医疗服务与融资方面的变化引发了对医学结果研究的兴趣。本研究旨在评估普通外科手术随时间推移对患者健康状况的影响。
对接受择期手术的患者，在术前、术后即刻以及术后三个月和六个月测量其功能健康状况。收集了俄亥俄州立大学医学中心普通外科服务的82例患者的完整数据，这些患者的症状涉及胆囊疾病（21例）、痔疮（10例）、腹股沟疝和切口疝（37例）以及临床重度肥胖（14例）。在手术前、术后首次就诊时以及术后三个月和六个月通过电话发放简短健康调查问卷36项简表。手术后查阅医院记录，并记录术前麻醉医生的风险状况、美国麻醉医师协会评分以及并发症情况。使用俄亥俄州立大学编制的问卷评估患者满意度。
对于所有四种择期手术，将术前功能与术后三个月和六个月的测量结果相比，健康状况均有显著改善。在评估的所有八个类别中改善均显著，包括身体、社会、心理、情绪和总体健康以及疼痛缓解。接受Roux-en-Y胃旁路手术治疗临床重度肥胖的患者报告有显著改善。
简短健康调查问卷36项简表被证明是评估择期手术后患者结果的有用工具。总体健康状况评估对于记录常规和创新疗法的有效性将特别有用。
