在年轻和年长的退伍军人中,术后康复的长期轨迹
Michael A Jacobs1, Carly A Jacobs1, Orna Intrator2,3
1Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.
JAMA surgery
|October 23, 2024
概括
大型手术的恢复有很大的差异,一些患者经历了长期的依赖. 了解这些长期术后恢复轨迹对于改善手术护理和患者的治疗结果至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 老年学是一门学科.
- 外科手术的结果
背景情况:
- 大型手术可能会导致长时间的康复或住院,对超过30天的长期结果的理解有限.
- 当前的外科注册表通常只捕捉短期的术后结果,阻碍了全面分析恢复轨迹.
研究的目的:
- 描述重大手术后患者的长期康复轨迹.
- 为了确定在术后期恢复和失去独立性的独特模式.
主要方法:
- 使用退伍军人事务 (VA) 数据 (2016-2019) 与居住历史相关的回顾性队列研究来跟踪医疗保健利用情况.
- 开发了潜在类,基于组的轨迹模型,以分析术后恢复模式.
- 患者被分为年轻人 (<65岁) 和老年人 (≥65岁) 的分组.
主要成果:
- 确定了五种不同的术后恢复轨迹,在年轻和老年患者群体中相似.
- 大多数患者 (T1,T2) 在60天内回家,而显著的少数人经历了长时间的康复 (T3) 或长期失去独立 (T4).
- 与年轻患者相比,老年患者在轨迹中占比较高,表明恢复延迟和长期失去独立性.
结论:
- 轨迹模型揭示了手术后恢复的临床显著变化,为手术决策提供了信息.
- 需要进行手术登记,将长期结果措施纳入手术登记,以更好地区分恢复模式.
- 识别患有长期依赖风险的患者对于有针对性的干预和改进外科治疗计划至关重要.
更多相关视频
相关概念视频
Peripheral Artery Disease V: Postoperative Nursing Management
3
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
3
Classification of Illness
7.4K
The meaning of illness is individualized to each person who experiences an alteration in health. In contrast, disease is a medical term indicating a pathological change in the structure and function of the body or mind. It is a condition that has specific symptoms and boundaries.
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe...
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe...
7.4K
The Effect of Aging on Tissues
2.1K
Several body functions deteriorate with age. The external signs of aging are easily identifiable. For example, the skin becomes dry, less elastic, and thins out, forming wrinkles. The skin of the face begins to appear looser due to a decrease in the levels of elastic and collagen fibers in the connective tissue. Additionally, melanin production in the hair follicle decreases with age, resulting in gray hair. Moreover, the senses of sight and hearing decline, so glasses and hearing aids may...
2.1K
Cardiomyopathy VII: Pre and Post Operative Nursing Management
2
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
2
Post-traumatic Stress Disorder
29
Post-traumatic stress disorder (PTSD) is a psychiatric condition that arises following exposure to traumatic events such as natural disasters, forced displacement, or severe accidents. It significantly impairs individuals' ability to cope with daily activities and disrupts their emotional and psychological equilibrium.
Symptoms and Behavioral Manifestations
A spectrum of distressing symptoms characterizes PTSD. Recurrent flashbacks, where individuals involuntarily relive traumatic events,...
Symptoms and Behavioral Manifestations
A spectrum of distressing symptoms characterizes PTSD. Recurrent flashbacks, where individuals involuntarily relive traumatic events,...
29
Appendicitis-II: Diagnostic Studies and Management
66
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
66


