生命末期手术患者的息性预后工具:系统性审查
Chuan-Whei Lee1, Aaron B Wong2, Smaro Lazarakis3
1Department of Anaesthesia and Pain Management, The Royal Melbourne Hospital, Melbourne, VIC, Australia; Department of Critical Care, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia.
British journal of anaesthesia
|April 24, 2025
概括
息预后工具 (PPT) 可以识别临近生命终点 (EOL) 的手术患者,显示死亡率增加. 需要进一步的研究,以将这些工具整合到手术前评估中,并改善患者的治疗结果.
科学领域:
- 手术瘤学手术瘤学
- 抚慰性护理是一种缓解性护理.
- 老年医学 老年医学
背景情况:
- 识别临终期 (EOL) 手术患者对于整合息和术后护理至关重要.
- 息预后工具 (PPT) 是建立的框架,用于评估处于过早死亡风险的患者.
- 本系统性审查审查了成人手术患者的PPT,它们对手术决策的影响以及术后结果.
研究的目的:
- 系统地审查成人手术患者的息性预后工具 (PPT) 的使用和影响.
- 评估PPT在手术决策中的作用.
- 确定PPT与术后结果之间的关联,包括死亡率和生活质量.
主要方法:
- 通过使用Ovid MEDLINE,EMBASE和Cochrane CENTRAL进行了一项系统性审查.
- 包括七项研究,评估了手术患者的四种不同的PPT.
- 由于研究异质性,数据合成是以叙述方式进行的.
主要成果:
- 12-61%的手术患者被PPT识别为生命末期 (EOL).
- 通过PPT识别EOL与增加住院和12个月死亡率有关.
- 缓和护理转诊和EOL文档在EOL手术患者中较低 (<15%),对手术决定的影响不确定.
结论:
- PPT显示了将其整合到手术前评估中的潜力.
- 未来的研究应该优先考虑术前EOL评估和患者报告的结果,如生活质量和决策满意度.
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