姑息性外科肿瘤患者是一类具有复杂需求的特殊群体，通常需要多学科协作，以提供及时和全面的护理。作者组建了一个多学科姑息干预团队，并评估了其与进行姑息干预的晚期癌症患者的护理目标讨论质量之间的关联。本前瞻性队列研究分析了从2019年10月至2022年3月，在一个单一的城市学术中心接受姑息干预治疗的晚期癌症患者。于2021年1月，组建了一个多学科姑息外科干预（MD-PALS）团队。所有姑息性外科肿瘤患者都在多学科会议上进行讨论，并由MD-PALS团队成员管理。构建了一个中断时间序列（ITS）模型，评估了MD-PALS实施与GOC讨论质量的关联，其质量是通过共识得出的四分GOC讨论质量评分测量的。该研究招募了126名姑息性外科肿瘤患者：前MD-PALS组44名患者，后MD-PALS组82名患者。两组在基线人口统计学、治疗、术后和生存结果方面没有显著差异。与前MD-PALS组相比，后MD-PALS组的GOC讨论质量评分均值显著较高（1.34 vs 2.61；p<0.001）。根据ITS模型，在MD-PALS团队实施后，患者季度平均GOC讨论质量评分显著增加（变化=1.93；95%可信区间，0.96-2.90；P=0.003）。MD-PALS团队的实施与姑息性外科肿瘤患者的GOC讨论质量的改善相关。© 2023. The Author(s).

Palliative surgical oncology patients represent a unique group with complex needs who often require multidisciplinary input for the provision of timely and holistic care. The authors assembled a multi-disciplinary palliative intervention team and evaluated its association with the quality of discussions on goals of care (GOC) among advanced cancer patients undergoing palliative interventions.This prospective cohort study analyzed advanced cancer patients undergoing palliative interventions at a single urban academic center from October 2019 to March 2022. In January 2021, a multi-disciplinary palliative surgical intervention (MD-PALS) team was assembled. All palliative surgical oncology patients were discussed at multi-disciplinary meetings and managed by members of the MD-PALS team. An interrupted time series (ITS) model was built to evaluate the association of MD-PALS implementation and the quality of GOC discussions as measured by a consensus-derived four-point GOC discussion quality score.The study recruited 126 palliative surgical oncology patients: 44 in the pre-MD-PALS group and 82 in the post-MD-PALS group. The two groups did not differ significantly in baseline demographics, treatment, or postoperative and survival outcomes. Compared with the pre-MD-PALS group, the post-MD-PALS group had a significantly higher mean GOC discussion quality score (1.34 vs 2.61; p < 0.001). Based on the ITS model, the average quarterly GOC discussion quality score increased significantly among patients after implementation of the MD-PALS team (change = 1.93; 95 % confidence interval, 0.96-2.90; P = 0.003).The implementation of an MD-PALS team was associated with improvements in the quality of GOC discussions among palliative surgical oncology patients.© 2023. The Author(s).