与量化表现相比,对30天术后功能的感知:影响80岁及以上患者感知功能衰退的因素
Meixi Ma1,2, Xane Peters1,3, Sarah Remer1,3
1American College of Surgeons, Division of Research and Optimal Patient Care, Chicago, IL.
Journal of the American College of Surgeons
|July 18, 2025
概括
年龄较大的成年人.
科学领域:
- 老年人手术的结果.
- 患者为中心的护理
- 功能评估在老年人的功能评估.
背景情况:
- 老年人优先考虑在手术后维持功能.
- 功能性结果可以通过主观感知和客观表现来评估.
- 确定影响术后功能衰退的因素对于这个年龄组至关重要.
研究的目的:
- 要确定感知到的身体功能 (PPF) 与日常生活活动 (ADLs) 的客观下降是否相关.
- 为了确定80岁及以上的患者手术后30天PPF恶化的危险因素.
主要方法:
- 利用了来自ACS NSQIP老年手术验证试点计划 (2015-2017) 的数据.
- 在PPF和ADL性能之间进行一致性分析时采用了奇平方测试.
- 使用多变量后勤回归来确定PPF恶化的风险因素.
主要成果:
- 包括5464名患者 (平均年龄85.7岁,63%为女性).
- 33%的人报告功能下降,而28%的人在30天后显示ADL性能恶化.
- 恶化PPF的危险因素包括较高的ASA类,骨科手术和手术前跌倒.
结论:
- 在老年手术患者的量化ADL表现和PPF之间存在显著的不一致.
- 直接评估患者感知到的身体功能是传统ADL评估的宝贵补充.
- 以患者为中心的功能评估是识别衰退和确保独立性的关键.
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