Effectiveness and Safety of Nurse Anesthetist-Led Preanesthesia Evaluation for Patients With Cancer: A Retrospective Observational Study With Coarsened Exact Matching Method.
Lin Yin, Yuanyuan Li, Dongmei Ma, Jiale Hu, Shuying Zhu, Xueqin Xia, Quan Yang, Jiang Zou, Limei Liao
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引用次数: 0
Abstract
Purpose: To investigate the effectiveness and safety of nurse anesthetist-led preanesthesia evaluation in patients with cancer.
Design: A retrospective observational study with a historical comparison group.
Methods: Data of patients with cancer and undergoing surgery and preanesthesia evaluation 1 year before and after the implementation of nurse anesthetist-led preanesthesia evaluation were collected from electronic medical systems. A coarsened exact matching approach was applied to match the pre- and post groups based on eight characteristic variables. The Student t test and the χ2 test were used for data analysis.
Findings: After matching, 8,393 patients both in the exposure and comparison groups were analyzed. The proportion of preanesthesia assessments completed before the day of surgery increased from 41.5% to 96.8%; the total number of cancellations of surgery decreased from 30 (0.36%) to 9 (0.11%) with substantial declines in procedure cancellations due to arrhythmia (10, 0.12% vs 0, 0%) and incomplete preoperative investigations (12, 0.14% vs 2, 0.02%). Unplanned stay in the postanesthesia care unit longer than 2 hours significantly decreased from 176 (2.1%) to 139 (1.66%). Other anesthesia-related outcomes were not significantly different.
Conclusions: Nurse anesthetist-led preanesthesia evaluation for cancer patients was effective and safe. Future studies should use a more rigorous study design or a parallel comparison to strengthen the findings in this area.
目的：探讨护理麻醉师主导的肿瘤患者麻醉前评估的有效性和安全性。设计：回顾性观察性研究，采用历史对照组。方法：从电子医疗系统中收集实施护士麻醉师主导的麻醉前评估前后1年的癌症手术患者及麻醉前评估的资料。采用基于8个特征变量的粗糙精确匹配方法对前后组进行匹配。数据分析采用Student t检验和χ2检验。结果：匹配后，暴露组和对照组的8,393例患者进行了分析。术前完成麻醉前评估的比例由41.5%上升至96.8%；取消手术的总数从30例（0.36%）下降到9例（0.11%），其中因心律失常（10.0.12% vs 0.0%）和术前检查不完全（12.0.14% vs 2.0.02%）而取消手术的人数大幅下降。麻醉后非计划住院时间超过2小时的患者从176例（2.1%）显著减少到139例（1.66%）。其他麻醉相关结果无显著差异。结论：护理麻醉师主导的肿瘤患者麻醉前评估是安全有效的。未来的研究应采用更严格的研究设计或平行比较来加强这一领域的研究结果。
期刊介绍：
The Journal of PeriAnesthesia Nursing provides original, peer-reviewed research for a primary audience that includes nurses in perianesthesia settings, including ambulatory surgery, preadmission testing, postanesthesia care (Phases I and II), extended observation, and pain management. The Journal provides a forum for sharing professional knowledge and experience relating to management, ethics, legislation, research, and other aspects of perianesthesia nursing.
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