{"title":"由执业护士管理的心血管手术的术后结果。","authors":"Masato Saitoh, Takuma Yamasaki, Tomoaki Tanabe, Shuichi Tochigi, Daiki Hirayama, Kiyotaka Aoyama, Imun Tei","doi":"10.1007/s11748-025-02132-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The significant workload of cardiovascular surgeons in Japan has led to a growing interest in implementing nurse practitioners as a means to address this issue. This study seeks to evaluate the postoperative outcomes of cardiovascular surgeries in which nurse practitioners were involved at our institution.</p><p><strong>Methods: </strong>This study utilized a retrospective observational study design. This study included patients who underwent scheduled cardiovascular surgeries at our hospital between April 1, 2019, and March 31, 2024. Patients were divided into two groups for postoperative care management: the DR group (physician only) and the NP group (co-management by physician and nurse practitioner). The primary end point was the 30-day mortality. We compared the two groups.</p><p><strong>Results: </strong>A total of 394 patients were classified into two groups: DR group (n = 101) and NP group (n = 293). There was no significant difference in the 30-day mortality between the two groups. The NP group had significantly shorter hospital stay (NP 20.6 ± 11.1 vs. DR 24.0 ± 11.8; p = 0.01; effect size = 0.299), postoperative length of stay (NP 14.5 ± 8.9 vs. DR 18.0 ± 10.4; p = 0.001; effect size = 0.376), ICU stay (NP 5.2 ± 3.5 vs. DR 6.3 ± 4.5; p = 0.014; effect size = 0.284), and time until 50-m walking (NP 3.8 ± 3.5 vs. DR 5.1 ± 5.1; p = 0.004; effect size = 0.342). There were no significant differences in the incidence of postoperative complications between the two groups.</p><p><strong>Conclusions: </strong>Nurse practitioners have the potential to provide safe care equivalent to that of physicians, and it may contribute to reduced hospital stays and improved postoperative recovery in patients.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Postoperative outcomes of cardiovascular surgery managed by nurse practitioners.\",\"authors\":\"Masato Saitoh, Takuma Yamasaki, Tomoaki Tanabe, Shuichi Tochigi, Daiki Hirayama, Kiyotaka Aoyama, Imun Tei\",\"doi\":\"10.1007/s11748-025-02132-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The significant workload of cardiovascular surgeons in Japan has led to a growing interest in implementing nurse practitioners as a means to address this issue. This study seeks to evaluate the postoperative outcomes of cardiovascular surgeries in which nurse practitioners were involved at our institution.</p><p><strong>Methods: </strong>This study utilized a retrospective observational study design. This study included patients who underwent scheduled cardiovascular surgeries at our hospital between April 1, 2019, and March 31, 2024. Patients were divided into two groups for postoperative care management: the DR group (physician only) and the NP group (co-management by physician and nurse practitioner). The primary end point was the 30-day mortality. We compared the two groups.</p><p><strong>Results: </strong>A total of 394 patients were classified into two groups: DR group (n = 101) and NP group (n = 293). There was no significant difference in the 30-day mortality between the two groups. The NP group had significantly shorter hospital stay (NP 20.6 ± 11.1 vs. DR 24.0 ± 11.8; p = 0.01; effect size = 0.299), postoperative length of stay (NP 14.5 ± 8.9 vs. DR 18.0 ± 10.4; p = 0.001; effect size = 0.376), ICU stay (NP 5.2 ± 3.5 vs. DR 6.3 ± 4.5; p = 0.014; effect size = 0.284), and time until 50-m walking (NP 3.8 ± 3.5 vs. DR 5.1 ± 5.1; p = 0.004; effect size = 0.342). There were no significant differences in the incidence of postoperative complications between the two groups.</p><p><strong>Conclusions: </strong>Nurse practitioners have the potential to provide safe care equivalent to that of physicians, and it may contribute to reduced hospital stays and improved postoperative recovery in patients.</p>\",\"PeriodicalId\":12585,\"journal\":{\"name\":\"General Thoracic and Cardiovascular Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2025-02-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"General Thoracic and Cardiovascular Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11748-025-02132-3\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"General Thoracic and Cardiovascular Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11748-025-02132-3","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
目的:在日本,心血管外科医生的工作量很大,这使得人们对实施执业护士作为解决这一问题的一种手段越来越感兴趣。本研究旨在评估在我们机构有执业护士参与的心血管手术的术后结果。方法:本研究采用回顾性观察研究设计。本研究纳入了2019年4月1日至2024年3月31日期间在我院接受心血管手术的患者。患者被分为两组进行术后护理管理:DR组(仅医生)和NP组(由医生和执业护士共同管理)。主要终点为30天死亡率。我们比较了两组。结果:394例患者分为DR组(101例)和NP组(293例)。两组患者的30天死亡率无显著差异。NP组住院时间明显缩短(NP 20.6±11.1比DR 24.0±11.8;p = 0.01;效应量= 0.299)、术后住院时间(NP 14.5±8.9 vs DR 18.0±10.4;p = 0.001;效应值= 0.376),ICU停留(NP博士5.2±3.5与6.3±4.5;p = 0.014;效应量= 0.284),步行至50米的时间(NP 3.8±3.5 vs DR 5.1±5.1;p = 0.004;效应值= 0.342)。两组术后并发症发生率无明显差异。结论:执业护士具有提供与医生相当的安全护理的潜力,并且可能有助于减少患者的住院时间和改善患者的术后恢复。
Postoperative outcomes of cardiovascular surgery managed by nurse practitioners.
Objective: The significant workload of cardiovascular surgeons in Japan has led to a growing interest in implementing nurse practitioners as a means to address this issue. This study seeks to evaluate the postoperative outcomes of cardiovascular surgeries in which nurse practitioners were involved at our institution.
Methods: This study utilized a retrospective observational study design. This study included patients who underwent scheduled cardiovascular surgeries at our hospital between April 1, 2019, and March 31, 2024. Patients were divided into two groups for postoperative care management: the DR group (physician only) and the NP group (co-management by physician and nurse practitioner). The primary end point was the 30-day mortality. We compared the two groups.
Results: A total of 394 patients were classified into two groups: DR group (n = 101) and NP group (n = 293). There was no significant difference in the 30-day mortality between the two groups. The NP group had significantly shorter hospital stay (NP 20.6 ± 11.1 vs. DR 24.0 ± 11.8; p = 0.01; effect size = 0.299), postoperative length of stay (NP 14.5 ± 8.9 vs. DR 18.0 ± 10.4; p = 0.001; effect size = 0.376), ICU stay (NP 5.2 ± 3.5 vs. DR 6.3 ± 4.5; p = 0.014; effect size = 0.284), and time until 50-m walking (NP 3.8 ± 3.5 vs. DR 5.1 ± 5.1; p = 0.004; effect size = 0.342). There were no significant differences in the incidence of postoperative complications between the two groups.
Conclusions: Nurse practitioners have the potential to provide safe care equivalent to that of physicians, and it may contribute to reduced hospital stays and improved postoperative recovery in patients.
期刊介绍:
The General Thoracic and Cardiovascular Surgery is the official publication of The Japanese Association for Thoracic Surgery and The Japanese Association for Chest Surgery, the affiliated journal of The Japanese Society for Cardiovascular Surgery, that publishes clinical and experimental studies in fields related to thoracic and cardiovascular surgery.