评估老年手术验证计划在脊椎外科手术中进行手术前沟通标准的性能
Nicole D Agaronnik1,2, Jocelyn L Streid3, Anne Kwok4
1Harvard Medical School, Boston, Massachusetts, USA.
Journal of the American Geriatrics Society
|January 17, 2024
概括
对接受高风险脊柱手术的老年患者进行手术前的沟通标准的文档非常低. 这凸显了需要在外科护理中更广泛地采用老年手术验证 (GSV) 计划标准的需要.
科学领域:
- 老年人手术是一门老年人手术.
- 手术沟通手术沟通
- 医疗保健服务研究 医疗服务研究
背景情况:
- 评估美国外科医生学院老年手术验证 (GSV) 计划在接受高风险脊柱手术的老年人中进行手术前的沟通标准.
- 评估这些标准的表现对于改善对这一弱势群体的护理至关重要.
研究的目的:
- 为外部验证一种自然语言处理 (NLP) 方法,用于识别GSV通信标准的文档.
- 将这种NLP方法应用于65岁及以上经历脊髓融合的患者的回顾性队列.
- 确定GSV通信领域的实现程度:整体健康目标,治疗目标和以患者为中心的结果.
主要方法:
- 用于识别GSV通信文档的NLP工具的外部验证.
- 对1294名患者 (≥65岁) 进行脊髓融合 (2018-2020年) 的回顾性分析.
- 用Poisson回归来评估与满足至少一个GSV域相关的因素.
主要成果:
- 通过NLP方法证明了高精度 (灵敏度为88.6%,特异性为99.0%).
- 只有0.8%的患者对所有三个GSV域都有记录;33.7%的患者至少遇到了一个.
- 总体健康目标是记录最少的领域 (2.7%). 患有并发症的患者表现出更高的满足率.
结论:
- 在接受脊椎手术的老年患者中,符合GSV标准的手术前文档不常见.
- 脊柱手术对老年人来说存在很高的风险,这使得GSV标准非常相关.
- 建议在外科专业中更广泛地实施和宣传GSV标准.
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