心血管外科和干预中的患者定义结果
1Division of Cardiothoracic Anesthesiology, Stanford University School of Medicine, Stanford, California.
Anesthesiology
|December 19, 2025
概括
患者定义的结果优先考虑患者的自主性和独立性,而不是仅仅生存. 这些患者主导的措施,如无残疾生存率,通过专注于更好地生活而不是更长时间来改善心血管保健.
科学领域:
- 心血管医学 心血管医学
- 以患者为中心的护理
- 健康 结果 研究 研究 结果
背景情况:
- 传统的心血管保健成功指标,如死亡率,对于接受复杂手术的老年人群来说是不够的.
- 患者报告的结果 (PROs) 捕捉了生活质量,但往往是临床医生框架,冗长,并且很难融入常规临床实践.
研究的目的:
- 引入和定义患者定义结果 (PDO) 作为PROs.的患者主导的演变.
- 突出 PDO 关注患者优先事项,如自主,独立,避免不良结果.
- 提出PDO作为可解释的,以自主性为中心的心血管护理终点.
主要方法:
- 与患者合作开发复合PDO,包括无残疾生存率和患者定义的不良事件.
- 概念框架对比PDO与传统的死亡基准和临床医生框架的PRO.
- 强调将PDO纳入心脏手术和干预工作流程中的术前评估和优化.
主要成果:
- PDO为传统的治疗结果提供了一个以患者为中心的替代方案,强调超越生存的生命质量.
- 无残疾生存率和患者定义的不良事件是可采取行动的PDO的例子.
- 保护产品名称是可解释的,以自主性为中心,与潜在的繁的PRO问卷不同.
结论:
- 患者定义的结果代表了评估心血管保健成功的范式转变.
- 将PDO整合到外科手术期间的工作流程中,使医疗干预与个体患者的目标和价值观保持一致.
- 产品有潜力通过优先考虑患者的福祉和改善生活质量来改变心血管保健.
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