患者报告问卷,以在手术前确定高风险的外科患者
Renske Meijer1,2, David W G Ten Cate3,4, Bart C Bongers5,4
1Department of Sports Medicine, Máxima Medical Centre, De Run 4600, 5504 DB, Veldhoven, The Netherlands. renske.meijer@mmc.nl.
Langenbeck's archives of surgery
|December 5, 2024
概括
像FitMáx和VSAQ这样的问卷可以通过估计心肺呼吸能力 (CRF) 来识别高风险的手术患者. 预测CRF低的患者应接受正式的手术前运动测试,以评估手术风险.
科学领域:
- 心脏病学 心脏病学
- 在手术前进行评估.
- 运动生理学 运动生理学
背景情况:
- 低心肺呼吸能力 (CRF) 与术后并发症和死亡率的增加有关.
- 通过心肺运动测试 (CPET) 进行CRF的术前评估是有价值的,但并非广泛可获得的.
- 在手术前确定高风险的手术患者对于优化结果至关重要.
研究的目的:
- 根据CRF,评估问卷在识别高风险手术患者方面的有效性.
- 为了比较FitMáx,DASI,M-DASI-4Q,VSAQ和MET问卷在预测VO2峰值方面的表现.
- 确定问卷的最佳切断值,以确定需要进一步手术前评估的患者.
主要方法:
- 参与者填写了多个CRF问卷,并接受了VO2峰值测量的CPET.
- 调查问卷预测的VO2峰值与CPET测量的VO2峰值进行了比较.
- 接收器操作特征 (ROC) 曲线分析,包括AUC,灵敏度,特异性和尤登指数,用于评估问卷表的性能.
主要成果:
- 所有问卷显示高AUC值用于识别高风险患者.
- 与其他问卷相比,FitMáx和VSAQ表现优越.
- 确定了FitMáx (例如,≤21.3毫升·公斤-1分钟-1) 和VSAQ (例如,≤18.2毫升·公斤-1分钟-1) 的最佳截止值,以标记患者进行进一步测试.
结论:
- FitMáx和VSAQ问卷是有效的工具,用于在手术前确定高风险的手术患者.
- 使用这些问卷预测低VO2峰值的患者应被转介到正式的手术前CPET.
- 这些验证的问卷提供了一个实际的替代方案,用于评估手术患者的CRF.
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