胸外科患者出院后远程症状监测

评估一种远程症状监测电子平台，通过患者症状报告来加强胸外科出院后护理。

Owing to the increased use of enhanced recovery after surgery protocols, patients are spending a larger portion of their postoperative course at home. For patients undergoing complex operations, this represents an opportunity for early identification of abnormal symptoms at home before deterioration.

由于术后强化恢复方案的使用越来越多，患者在家中度过了更大比例的术后疗程。对于接受复杂手术的患者来说，这是在病情恶化之前在家中早期发现异常症状的机会。

An online symptom-tracking platform for thoracic surgery patients was created on the basis of opinions from stakeholders and a review of the literature. Starting in February 2021, patients were educated about the symptom tracker in preoperative clinics. After discharge, patients received a series of electronic surveys covering 23 symptom domains assessed using a Likert scale for severity. Moderate symptoms prompted a "yellow alert," and severe symptoms prompted a "red alert," both notifying the nursing team and prompting appropriate action. Patients were considered responders if they completed at least 1 survey.

根据利益相关者的意见和文献综述，为胸外科患者创建了一个在线症状跟踪平台。从2021年2月开始，患者在术前诊所接受了症状跟踪器的教育。出院后，患者接受了一系列电子调查，涵盖23个症状领域，使用李克特严重程度量表进行评估。中度症状提示“黄色警报”，重度症状提示“红色警报”，通知护理团队并提示采取适当行动。如果患者完成了至少一项调查，则被视为应答者。

In total, 1997 patients were enrolled; 76% (n=1520) were responders. Responders were younger, more likely to be White, less likely to have medical comorbidities, and less likely to be readmitted (odds ratio, 0.53 [95% CI, 0.37-0.76]; P<0.001). Responders who were readmitted had a higher percentage of red alerts (47% vs. 24%; P<0.001) and yellow alerts (74% vs. 61%; P=0.016), compared with responders who were not readmitted.

共纳入患者1997例；76%（n=1520）为应答者。受访者更年轻，更有可能是白人，不太可能有医疗并发症，也不太可能再次入院（OR，0.53[95%CI，0.37-0.76]；P<0.001）。与未重新入院的应答者相比，重新入院的响应者有更高比例的红色警报（47%对24%；P<0.001）和黄色警报（74%对61%；P=0.016）。

Electronic reporting adds an additional mechanism of communication between the patient and the clinical team, with the potential to lower the odds of readmission.

电子报告系统为患者和临床团队之间增加了一种额外的沟通机制，有可能降低再次入院的几率。