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Adding Patient-reported Outcomes to the American College of Surgeons National Surgical Quality Improvement Program: Results of the First 33,842 Patients From 65 Hospitals.
Liu, Jason B; Pusic, Andrea L; Melucci, Alexa D; Brajcich, Brian C; Fordham, Matthew J; Lapsley, Jakob C; Ko, Clifford Y; Temple, Larissa K F.
Afiliación
  • Liu JB; Patient-Reported Outcomes, Value, and Experience Center, Brigham and Women's Hospital, Boston, MA.
  • Pusic AL; Harvard Medical School, Boston, MA.
  • Melucci AD; Division of Surgical Oncology, Brigham and Women's Hospital, Boston, MA.
  • Brajcich BC; Patient-Reported Outcomes, Value, and Experience Center, Brigham and Women's Hospital, Boston, MA.
  • Fordham MJ; Harvard Medical School, Boston, MA.
  • Lapsley JC; Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital, Boston, MA.
  • Ko CY; Surgical Health Outcomes and Research for Equity (SHORE) Center, Department of Surgery, University of Rochester Medical Center, Rochester, NY.
  • Temple LKF; Division of Colon and Rectal Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY.
Ann Surg ; 280(3): 383-393, 2024 Sep 01.
Article en En | MEDLINE | ID: mdl-38860381
ABSTRACT

OBJECTIVE:

To investigate the initial set of patient-reported outcomes (PROs) in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) and their associations with 30-day surgical outcomes.

BACKGROUND:

PROs provide important information that can be used to improve routine care and facilitate quality improvement. The American College of Surgeons conducted a demonstration project to capture PROs into the NSQIP to complement clinical data.

METHODS:

From February 2020 to March 2023, 65 hospitals collected Patient-Reported Outcomes Measurement Information System measures assessing global health, pain interference, fatigue, and physical function from patients accrued into the NSQIP. Using multivariable mixed regression, we compared the scores of patients with and without 30-day complications and further analyzed scores exceeding 1-SD worse than national benchmarks.

RESULTS:

Overall, 33842 patients completed the Patient-Reported Outcomes Measurement Information System measures with a median of 58 days (IQR 47-72) postoperatively. Among patients without complications (n = 31210), 33.9% had PRO scores 1-SD worse than national benchmarks. Patients with complications were 1.7 times more likely to report worse PROs (95% CI 1.6-1.8). Patients with complications had lower scores for global physical health [adjusted mean difference (AMD) 2.6, 95% CI 2.2-3.0], lower for global mental health (AMD 1.8, 95% CI 1.4-2.2), higher for pain interference (AMD 2.4, 95% CI 2.0-2.8), higher fatigue (AMD 2.7, 95% CI 2.3-3.1), and lower physical function (AMD 3.2, 95% CI 2.8-3.5).

CONCLUSIONS:

Postoperative complications negatively affect multiple key dimensions of patients' health-related quality of life. PROs were well below national benchmarks for many patients, even among those without complications. Identifying solutions to improve PROs after surgery remains a tremendous quality improvement opportunity.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Mejoramiento de la Calidad / Medición de Resultados Informados por el Paciente Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Ann Surg Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Mejoramiento de la Calidad / Medición de Resultados Informados por el Paciente Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Ann Surg Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos