The implementation of an electronic symptom management system to monitor postoperative pain in thoracic surgery patients: A multicenter evaluation

IF 1.9
Jorind Beqari MD , Jacob Hurd BS , Angela C. Tramontano MPH , Christine Cronin BS , Alexandra Potter BS , Sandra Wong MD , Deborah Schrag MD, MPH , Don S. Dizon MD , Jessica Bian MD , Raymond U. Osarogiagbon MD , Hannah Hazard-Jenkins MD , Joseph D. Phillips MD , Abbas E. Abbas MD , Isha Mehta Warikoo MD , Mitchell Anderson , Kenneth P. Seastedt MD, MBA , Michael Lanuti MD , Yolonda L. Colson MD, PhD , Cameron D. Wright MD , Michael Hassett MD, MPH , Chi-Fu Jeffrey Yang MD
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引用次数: 0

Abstract

Objective

Few studies have evaluated postoperative recovery of patients after thoracic surgery using patient-reported outcome measures. This multi-institutional study analyzed postoperative pain and opioid use among patients undergoing thoracic surgery based on patient-reported outcome measures data collected through an electronic symptom management system.

Methods

The electronic symptom management system is a multi-symptom questionnaire based on a Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events that is integrated into the electronic health record and administered via the patient portal. Patients undergoing lung resections were invited to complete electronic symptom surveys within the electronic symptom management system during their 90-day postoperative period. Baseline patient demographics, surgical data, and postoperative opioid data were gathered from the electronic health record. Multivariable hierarchical regression was used to evaluate predictors of postoperative pain and opioid prescriptions.

Results

Of 680 patients who met the inclusion criteria, 258 (37.9%) reported at least 1 severe pain score. Patients reporting severe pain were more likely to have undergone open surgery, to receive at least 1 postoperative opioid prescription, and to become persistent opioid users compared with patients reporting no severe pain. In multivariable logistic regression analysis, the only factor associated with a severe pain score was female sex (odds ratio, 1.67, 95% CI, 1.17-2.39; P = .005).

Conclusions

This multicenter study used patient-reported outcome measures to evaluate predictors of postoperative pain and opioid prescriptions in patients undergoing thoracic surgery. Further investigation into the administration of patient-reported outcome measures is needed to assess their ability to impact postsurgical care and postoperative outcomes.
应用电子症状管理系统监测胸外科患者术后疼痛:多中心评估
目的很少有研究使用患者报告的结果指标来评估胸外科手术后患者的术后恢复情况。这项多机构研究基于通过电子症状管理系统收集的患者报告的结果测量数据,分析了胸外科手术患者的术后疼痛和阿片类药物使用情况。方法电子症状管理系统是基于不良事件通用术语标准的患者报告结果版本的多症状问卷,该问卷集成到电子健康记录中并通过患者门户进行管理。邀请肺切除术患者在术后90天的电子症状管理系统内完成电子症状调查。从电子健康记录中收集基线患者人口统计数据、手术数据和术后阿片类药物数据。采用多变量分层回归评估术后疼痛和阿片类药物处方的预测因素。结果在符合纳入标准的680例患者中,258例(37.9%)报告了至少1项严重疼痛评分。报告严重疼痛的患者与报告无严重疼痛的患者相比,更有可能接受开放手术,接受至少1次术后阿片类药物处方,并成为持续的阿片类药物使用者。在多变量logistic回归分析中,与严重疼痛评分相关的唯一因素是女性(优势比,1.67,95% CI, 1.17-2.39;P = .005)。结论:这项多中心研究采用患者报告的结局指标来评估胸外科手术患者术后疼痛和阿片类药物处方的预测因素。需要进一步调查患者报告的结果措施的管理,以评估其影响术后护理和术后结果的能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
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