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影响老年患者大肠癌治疗切除术后死亡率的因素
L P Fielding1, R K Phillips, R Hittinger
1Large Bowel Cancer Project, Academic Surgical Unit, St Mary's Hospital, London.
Lancet (London, England)
|March 18, 1989
概括
70岁以上接受结肠直肠癌手术的老年患者在医院死亡率较高. 心肺复杂症和晚期疾病是关键因素,需要对这一群体进行早期检测和量身定制的治疗.
科学领域:
- 在瘤学瘤学.
- 老年医学 老年医学
- 外科手术的结果
背景情况:
- 结肠直肠癌对健康构成重大挑战,结果因患者年龄和临床表现而异.
- 了解影响住院死亡率的因素对于改善手术护理至关重要,特别是在老年人群中.
研究的目的:
- 分析接受结直肠癌治愈切除术的患者的死亡率,特别关注70岁及以上的患者.
- 在结直肠癌手术中确定与住院死亡率相关的临床因素.
主要方法:
- 来自大肠癌项目的死亡率数据的回顾性分析.
- 老年人 (≥70岁) 和年轻患者队列之间的结果比较.
- 确定风险因素,包括年龄,阻塞,穿孔和术后并发症.
主要成果:
- 治疗性结直肠癌切除的整体住院死亡率为7%.
- 70岁以上的患者占死亡人数比例不成比例 (78%),尽管他们占研究人口的46%.
- 心肺复杂症占所有住院死亡的55%.
结论:
- 在结直肠癌手术中的住院死亡率主要受到临床因素的影响,而不是病理特征.
- 高龄,阻塞和穿孔是外科手术结果的重要不利因素.
- 减少老年患者死亡率的策略包括早期诊断,彻底的手术前评估,警的术后心肺监测以及考虑局部治疗.
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