患者报告了在床边获得的与健康相关的社会需求,以及选择性大手术后的结果
Kurt S Schultz1, Miranda S Moore2, Emily Y Park2
1Division of Colon & Rectal Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT. Electronic address: https://x.com/SchultzKurt.
Surgery
|September 17, 2025
概括
报告与健康相关的社会需求的患者经历了更大的手术后的30天并发症. 这凸显了在手术护理中解决健康的社会决定因素的重要性,以改善患者的治疗结果.
科学领域:
- 手术结果研究研究.
- 医疗保健服务研究 医疗服务研究
- 健康的社会决定因素
背景情况:
- 越来越多的证据将健康的社会决定因素 (SDOH) 与手术结果联系在一起.
- 在术后期了解患者层面的社会需求方面存在差距.
- 本研究通过检查与健康相关的社会需求 (HRSN) 和手术并发症来解决这一差距.
研究的目的:
- 评估患者报告的HRSN与手术并发症之间的关联.
- 调查HRSN对外科手术后期结果的影响.
- 在HRSN数据收集中使用常规的床边查工具.
主要方法:
- 对接受选择性重大胸部或腹部手术的患者进行回顾性研究.
- 使用可问责卫生社区 (AHC) 工具对4个核心HRSN域进行查 (2022年1月至2023年6月).
- 将查数据与胸部外科医生协会和国家外科质量改善计划数据库联系起来.
主要成果:
- 包括356名胸部和816名腹部手术患者;6.1%的人报告至少有一个HRSN.
- 患有HRSN的患者30天后术后并发症的几率是1.8倍 (OR,1.78;P=.043).
- HRSN与更长的住院时间和降低退院到永久居留的可能性有关.
结论:
- 这项研究是首次将AHC HRSN查数据与外科手术结果联系起来.
- 报告HRSN的患者在重大手术后面临更高的并发症率.
- 需要进一步的研究来确定特定的HRSN导致手术护理不平等,并为手术前干预提供信息.
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