术前康复在降低择期心脏手术患者术后肺部并发症发生率方面的作用:手术前检查小组的研究结果。

IF 3.7 3区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Kardiologia polska Pub Date : 2024-10-08 DOI:10.33963/v.phj.102770
Dorota Sobczyk, Jacek Osiewalski, Hubert Hymczak, Dominika Batycka-Stachnik, Sylwia Wiśniowska-Śmiałek, Bogusław Kapelak, Krzysztof Bartuś
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引用次数: 0

摘要

背景:目的:"术前检查小组 "研究旨在评估跨学科综合评估和康复计划的实施对择期心脏手术后肺部并发症发生率的影响。方法:725 名成年患者(研究组 338 人,对照组 387 人)被纳入这项单中心、前瞻性、观察性研究。多模式术前康复包括四项内容:由心脏科医生、麻醉科医生和心脏外科医生进行的跨学科医疗评估;针对术后肺部并发症高危患者的肺部评估;心理评估;以及物理治疗评估和训练。主要终点是术后肺部并发症的发生率,次要终点是手术部位感染、再次胸廓切开术、重症监护室住院时间和住院时间:结果:术前康复将术后并发症的数量减少了 23%。术后肺炎在康复前检查组中减少了近 3 倍(5.33% 对 14.21%),手术部位感染在康复前检查组中减少了 1.4 倍(8.28% 对 11.37%)。在逻辑回归模型中,术前康复可降低术后肺炎几率(0.346)和呼吸衰竭几率(0.479)。康复训练对重症监护室的住院时间没有直接影响:结论:根据术前检查小组标准进行术前康复可降低择期心脏手术患者术后肺部并发症的发生率和术后并发症的总数。参加术前检查小组访视的主要好处是有机会进行术前支持性干预。
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The role of prehabilitation in reducing the incidence of postoperative pulmonary complications in patients undergoing elective cardiac surgery: Results from the Pre Surgery Check Team study.

Background: Despite its importance, prehabilitation, has only been implemented in very few cardiac surgery centers.

Aims: The Pre Surgery Check Team study was designed to evaluate the impact of comprehensive interdisciplinary assessment and implementation of the prehabilitation program on the incidence of postoperative pulmonary complications after elective cardiac surgery.

Methods: 725 adult patients (338 in the study group, 387 in the control group) were included in this single-center, prospective, observational study. Multimodal prehabilitation consisted of four elements: interdisciplinary medical assessment by cardiologist, anesthesiologist and cardiac surgeon, pulmonary assessment for patients at high risk of postoperative pulmonary complications, psychological assessment, and physiotherapeutic assessment and training. The primary endpoint was the occurrence of the postoperative pulmonary complications, and the secondary outcomes were: surgical site infection, rethoracotomy, ICU length of stay and hospital length of stay.

Results: Prehabilitation reduced the number of postoperative complications by 23%. Postoperative pneumonia was almost 3 times less common (5.33% vs 14.21%), and the surgical site infection - 1.4 times less common in the PreScheck group (8.28 vs 11.37%). In the logistic regression model, prehabilitation reduced the odds of postoperative pneumonia (by 0.346) and the odds of respiratory failure (by 0.479). Prehabilitation had no direct effect on ICU length of stay.

Conclusions: Prehabilitation according to the Pre Surgery Check Team standard reduces the incidence of postoperative pulmonary complications and the total number of postoperative complications in patients undergoing elective cardiac surgery. The main benefit of attending the PreScheck Team visit is the opportunity to perform supportive preoperative interventions.

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来源期刊
Kardiologia polska
Kardiologia polska 医学-心血管系统
CiteScore
3.00
自引率
24.20%
发文量
431
审稿时长
3-6 weeks
期刊介绍: Kardiologia Polska (Kardiol Pol, Polish Heart Journal) is the official peer-reviewed journal of the Polish Cardiac Society (PTK, Polskie Towarzystwo Kardiologiczne) published monthly since 1957. It aims to provide a platform for sharing knowledge in cardiology, from basic science to translational and clinical research on cardiovascular diseases.
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