基于患者报告结局的心脏外科恢复评价量表选择专家共识  

Expert consensus on the selection of postoperative recovery evaluation scale for cardiac surgery patients based on patient-reported outcomes

作　　者：国家心血管系统疾病质量控制中心心脏外科专业专家组 李伊琤 焦中禹 张捷轩 张默 张智翔 孙润宸 林深 郑哲 The Expert Group for Cardiac Surgery of National Center for Cardiovascular Quality Control;ZHENG Zhe(Department of Cardiac Surgery,Fuwai Hospital,Chinese Academy of Medical Sciences,Beijing,100037,P.R.China;不详)

机构地区：[1]中国医学科学院阜外医院心脏外科,北京100037 [2]中国医学科学院阜外医院

出　　处：《中国胸心血管外科临床杂志》2025年第4期427-436,共10页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：中央高水平医院临床科研专项(2022-GSP-GG-28);中国医学科学院医学与健康科技创新工程(2021-I2M-1-063)。

摘　　要：心脏外科手术因其创伤性大,常导致患者恢复体验不佳。随着心血管外科技术的进步,手术死亡率及并发症发生率显著降低,患者术后的主观恢复体验受到更多关注。患者报告结局(patient-reported outcomes,PROs)是指患者直接报告的关于自身健康状况、功能状态和治疗感受的反馈,对其进行准确评估与及时干预逐渐成为学术热点,部分PROs的改善甚至与预后获益存在显著相关性。然而,心脏外科术后恢复需要关注PROs的哪些维度以及各维度评价量表如何选择仍存在争议。我们参考国内外研究进展,结合国内外临床实践,广泛征求专家意见,对心脏外科患者术后PROs的评价维度达成共识,包括患者综合恢复情况(手术恢复、生活质量)及其9个维度(疼痛、生理、睡眠、口渴、衰弱、活动、认知、精神心理和社会支持)。本共识综合考量PROs量表应用情况,各维度选取了1~3个应用最广泛、证据最充分的量表进行介绍,以进一步规范我国心脏外科术后恢复PROs评价维度及各维度量表的选择。Cardiac surgery is often associated with significant trauma,which can lead to a suboptimal recovery experience for patients.With advancements in cardiovascular surgical techniques,the rates of surgical mortality and complications have significantly decreased,leading to increased attention on patients'subjective recovery experiences after the surgery.Patient-reported outcomes(PROs)refer to the feedback provided directly by patients regarding their health status,functional abilities,and treatment experiences.Accurate assessment and timely intervention of PROs have become a growing area of interest in the academic community,with improvements in certain PROs showing significant correlations with prognostic benefits.However,there remains controversy regarding which dimensions of PROs should be prioritized in the postoperative recovery of cardiac surgery patients and how to select appropriate evaluation scales for these dimensions.We referenced the research progress both domestically and internationally,combined with clinical practices from around the world,and widely solicited expert opinions to reach a consensus on the evaluation dimensions of postoperative PROs for cardiac surgery patients.This includes the overall recovery status of patients(surgical recovery,quality of life)and its nine dimensions(pain,physiology,sleep,thirst,frailty,activity,cognition,mental health,and social support).This consensus comprehensively considers the application of PROs scales,and introduces 1-3 scales with the widest application and most solid evidence for each dimension,aiming to further standardize the evaluation dimensions of PROs after cardiac surgery in China and the selection of scales for each dimension.

关 键 词：心脏外科 患者报告结局测量 术后恢复 专家共识 

分 类 号：R654.2[医药卫生—外科学]