"抛旗":患者行为报告影响了骨科创伤手术后的结果
Nathaniel P Mercer1, Alexander J Egol, Sophia Jacobi
1NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY.
骨科创伤患者的电子健康记录 (EHR) 行为标志与骨折固定后严重并发症和重新手术的增加有关. 术前标志显示了与不良结果的最强相关性,表明术后风险升高.
科学领域:
- 整形外科手术 整形外科手术
- 创伤护理 创伤护理
- 医疗信息学 医疗信息学
背景情况:
- 电子健康记录 (EHR) 越来越多地包含行为标志来记录患者的行为.
- 这些标志对手术结果的影响,特别是在骨科创伤中,仍未得到充分研究.
研究的目的:
- 评估基于EHR的行为标志指标与骨科创伤患者的术后结果之间的关联.
- 确定手术前的行为标志是否与更高的不良外科结果风险有关.
主要方法:
- 追溯性队列研究使用1:1的倾向性得分匹配.
- 包括成人骨科创伤患者进行急性骨折的手术固定.
- 对重大术后并发症和重新手术的1年率的分析.
主要成果:
- 与没有标志的对照组相比,具有行为标志的患者出现重大并发症 (OR 5.57) 和重新手术 (OR 4.06) 的几率明显更高.
- 手术前的行为标志与重大并发症的几率最高相关 (OR 14.74).
- 在匹配后实现了充分的共变量平衡,随访时间中位数为12个月.
结论:
- 在EHR行为标志的指定与骨科创伤中增加了严重的术后并发症和重复手术有关.
- 术前行为标志是术后风险升高的强有力的指标.
- 行为标志可以作为一种有价值的标志物,用于识别患有不良结果风险较高的患者.
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