在紧急一般手术后,与代码状态变化相关的因素的识别
Shruthi Srinivas1, Michael E Villarreal2, Holly Baselice1
1Department of Trauma and Acute Care Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
The Journal of surgical research
|October 27, 2023
概括
在外科急诊中确定代码状态变化 (CSC) 的因素至关重要. 老年患者,转移患者,具有更多的并发病,器官衰竭,贫血或活跃癌症的患者, postoperative CSC 的几率更高.
科学领域:
- 紧急医疗 紧急医疗
- 手术重症监护手术重症监护
- 患者的治疗结果.
背景情况:
- 手术紧急情况需要快速决策.
- 将手术干预与患者价值观相协调,需要了解护理的目标.
- 代码状态更改 (CSC) 可以表明手术后患者目标的转变.
研究的目的:
- 确定与急性改变护理目标相关的患者因素.
- 使用术后代码状态更改 (CSC) 作为患者目标转移的代理.
- 为接受紧急手术的患者进行手术前讨论提供信息.
主要方法:
- 对单一机构数据的回顾性分析.
- 分析了接受紧急腹腔切除术的患者.
- 基于手术后的骨髓瘤和统计分析进行了分层分类.
主要成果:
- 在484名患者中,13.8%的患者经历了手术后的CSC.
- 年龄较大,机构间转移,较高的并发症指数和较高的快速SOFA分数与CSC有关.
- 贫血和活跃癌症也增加了CSC的几率.
结论:
- 紧急手术患者的一个子集经历了手术后的CSC,过渡到舒适护理.
- 识别患有CSC风险较高的患者至关重要.
- 暂停临床势头可以确保这些高风险患者的目标一致的护理.
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