动员和复合术后并发症之间的关联,主要选择性手术后的复合术后并发症
Alparslan Turan1,2, Ashish K Khanna3,4,5, Jack Brooker1
1Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio.
JAMA surgery
|May 31, 2023
概括
通过加速度计追踪的术后动员增加,大大减少了手术并发症和住院时间. 早期的患者流动性对于更好的外科康复结果至关重要.
科学领域:
- 手术成果研究的研究结果.
- 监测患者的康复,监测患者的康复.
- 医疗保健中的可穿戴技术
背景情况:
- 早期动员是手术后增强恢复 (ERAS) 协议的基石.
- 量化术后患者动员对康复的影响对于优化手术途径至关重要.
研究的目的:
- 评估术后动员和手术并发症组合之间的关联.
- 评估动员和住院时间,疼痛评分和30天再入院率之间的关系.
主要方法:
- 对8653名接受重大选择性手术的患者进行了回顾性观察性研究.
- 在手术后的前48小时内使用可穿戴加速度计测量动员.
- 综合结局的分析,包括心肌损伤,腹膜,中风,静脉血栓栓塞,肺部并发症和住院死亡率.
主要成果:
- 每增加4分钟的每小时动员时间都与复合结果减少25%有关 (HR,0.75;95% CI,0.67-0.84).
- 增加动员与每4分钟增加的住院时间中位数减少0.12天相关 (95% CI,0.09-0.15).
- 动员和疼痛评分或30天再入院之间没有发现显著的关联.
结论:
- 术后动员,客观地通过加速度计测量,与更少的并发症和更短的住院时间有关.
- 可穿戴技术可以有效地监测患者的移动性,以预测和潜在地减轻不良的外科结果.
- 调查结果支持将客观动员监测纳入增强恢复途径.
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