对于急性术后疼痛患者报告结果的最小临床重要变化
Jan Vollert1, Vasco M Egert2, Daniel Segelcke3
1Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom; and Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, Germany.
Anesthesiology
|October 9, 2025
概括
这项研究计算了手术后患者报告的结果指标 (PROM) 的临床重要差异最小值 (MCID). 基线疼痛显著影响患者认为疼痛和功能有意义的变化.
科学领域:
- 手术结果研究研究.
- 患者报告的结果措施 (PROMs)
- 临床意义评估评估
背景情况:
- 患者报告的结果测量 (PROM) 对于从患者的角度评估术后疼痛和功能至关重要.
- 最小临床重要差异 (MCID) 量化了患者认为具有意义的PROM中最小的变化.
- 了解MCID对于解释治疗有效性和指导临床决策至关重要.
研究的目的:
- 计算各种PROM的MCID值,以评估术后疼痛强度和身体功能.
- 对MCID估计进行敏感性分析.
- 为了研究基线疼痛严重程度对MCID值的影响.
主要方法:
- 这是一项多中心研究,涉及10个欧洲国家的2661名患者.
- 在手术后的第1天和第3天收集了八个PROM测量疼痛和身体功能的数据.
- 使用基于分布和基于的结合方法来确定MCID.
主要成果:
- 对疼痛强度的MCID估计在1.2至1.6之间;对于身体功能,它们在1.5至1.6之间 (以11分级).
- 敏感性分析显示,在症状改善和恶化之间,在MCID中没有显著差异.
- 较高的基线疼痛与较高的MCID值相关,表明严重疼痛的患者需要更大的改变来感知改善.
结论:
- 对于与疼痛和身体功能相关的PROMs的MCID估计存在显著差异.
- 基线疼痛水平在很大程度上影响了患者对最小的相关变化的看法.
- 未来的研究应该考虑基线值在解释MCID在术后患者.
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