AIM: To establish a scoring system for predicting the incidence of postoperative complications and mortality in general surgery based on the physiological and operative severity score for the enumeration of mortality ...AIM: To establish a scoring system for predicting the incidence of postoperative complications and mortality in general surgery based on the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM), and to evaluate its efficacy. METHODS: Eighty-four patients with postoperative complications or death and 172 patients without postoperative complications, who underwent surgery in our department during the previous 2 years, were retrospectively analyzed by logistic regression. Fifteen indexes were investigated including age, cardiovascular function, respiratory function, blood test results, endocrine function, central nervous system function, hepatic function, renal function, nutritional status, extent of operative trauma, and course of anesthesia. Modified POSSUM (M-POSSUM) was developed using significant risk factors with its efficacy evaluated. RESULTS: The significant risk factors were found to be age, cardiovascular function, respiratory function, hepatic function, renal function, blood test results, endocrine function, nutritional status, duration of operation, intraoperative blood loss, and course of anesthesia. These factors were all included in the scoring system. There were significant differences in the scores between the patients with and without postoperative complications, between the patients died and survived with complications, and between the patients died and survived without complications. The receiver operating characteristic curves showed that the M-POSSUM could accurately predict postoperative complications and mortality.CONCLUSION: M-POSSUM correlates well with postoperative complications and mortality, and is more accurate than POSSUM.展开更多
文摘AIM: To establish a scoring system for predicting the incidence of postoperative complications and mortality in general surgery based on the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM), and to evaluate its efficacy. METHODS: Eighty-four patients with postoperative complications or death and 172 patients without postoperative complications, who underwent surgery in our department during the previous 2 years, were retrospectively analyzed by logistic regression. Fifteen indexes were investigated including age, cardiovascular function, respiratory function, blood test results, endocrine function, central nervous system function, hepatic function, renal function, nutritional status, extent of operative trauma, and course of anesthesia. Modified POSSUM (M-POSSUM) was developed using significant risk factors with its efficacy evaluated. RESULTS: The significant risk factors were found to be age, cardiovascular function, respiratory function, hepatic function, renal function, blood test results, endocrine function, nutritional status, duration of operation, intraoperative blood loss, and course of anesthesia. These factors were all included in the scoring system. There were significant differences in the scores between the patients with and without postoperative complications, between the patients died and survived with complications, and between the patients died and survived without complications. The receiver operating characteristic curves showed that the M-POSSUM could accurately predict postoperative complications and mortality.CONCLUSION: M-POSSUM correlates well with postoperative complications and mortality, and is more accurate than POSSUM.
文摘目的探究绿色护理通道在急诊创伤性休克患者中的应用。方法特就2019年9月至2021年2月总体研究时段中甄选出就天津市宝坻区人民医院行急诊创伤性休克治疗的120例患者作为样本对象。依据SPSS 22.0软件生成的随机分组序列均分成组,每组60例。对照组予以常规急救措施,观察组联合运用绿色护理通道干预。评估比对两组对象急救处理时间、各项抢救相关指标以及患者家属对护理质量满意度情况。结果观察组对象急救反应时间(6.23±2.68)min与抢救总时间(45.32±6.22)min均较大程度短于对照组[(10.59±3.35)min、(62.72±8.46)min],差异有统计学意义(t/P值:7.872/<0.001;12.836/<0.001);该组对象多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)发生率(3.33%)、窒息发生率(1.67%)均低于对照组(13.33%、13.33%);抢救成功率(100%)则高于对照组(90.00%),差异有统计学意义(χ^(2)/P值:3.927/0.048;-/0.032;-/0.027);且该组对象家属就护理质量满意率(98.33%)高于对照组(85.00%),差异有统计学意义(χ^(2)/P值:6.982/0.008)。结论相较于传统急诊护理模式,在急诊创伤性休克患者中建立绿色护理通道进行干预能有效缩短抢救时间、降低MODS发生率和患者窒息率,提高抢救成功率与患者家属满意度。
