加速康复外科患者住院时间延长影响因素的研究现状及展望

Risks of extending the length of stay in patients under enhanced recovery after surgery:current status and expectations

住院时间缩短是加速康复外科(ERAS)临床效果的主要指标之一,但受统计、制度、医方及患方等主客观因素的影响,部分经ERAS路径干预患者的术后住院时间并未较传统康复路径明显缩短,使医患实施ERAS的积极性和依从性受到严重影响,因此,探究ERAS患者住院时间延长相关影响因素意义重大,有利于准确预测患者住院时间并采取针对性措施进行干预,持续改进、不断优化、逐步规范ERAS路径,进一步缩短患者住院时间,降低医疗费用,促进ERAS推广和应用,造福外科手术患者。本文就目前ERAS患者住院时间延长影响因素的研究现状进行综述,分析导致ERAS患者住院时间延长的其他可能因素,并对未来工作的改进措施提出展望。

Shortening the length of stay(LOS)is one of the major indicators to assess the efficacy of enhanced recovery after surgery(ERAS).Due to the influencing factors from the aspects of health care providers,patients,health care system and statistical methods,however,the LOS of some patients under ERAS was not significantly reduced compared with those undergoing conventional recovery measures.These compro-mised the confidence and compliance of medical providers and patients in implementing ERAS.Therefore,it is of great significance to explore the risk factors of extending LOS,so as to predict the LOS of patients accurately and facilitate further optimization and standardization of the ERAS path.These will benefit the surgical patients on further shortening the LOS,reducing medical costs,promoting the application of ERAS.Here,we reviews the current status on the risk factors of extending LOS in patients under ERAS,and explores other possible factors influencing LOS with expectation to improve ERAS path in future.