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覆盖性手术与外科手术后果的关联

Eric Sun^1,2, Michelle M Mello^2,3, Chris A Rishel¹

¹Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California.

|February 27, 2019

概括

大多数患者的重叠手术并没有增加死亡率或并发症,但确实增加了手术时间. 在重叠手术期间,高风险患者的死亡率和并发症增加.

科学领域:

手术结果研究
患者安全
医疗服务研究

背景情况:

一个外科医生同时进行多项手术的重叠手术引发了关于患者安全和潜在不良结果的担忧.
了解重叠手术对死亡率,并发症和手术持续时间的影响对于手术实践和患者护理至关重要.

研究的目的:

研究重叠手术与住院死亡率,术后并发症和手术时间之间的关联.
在重叠的手术过程中,确定特定的患者子组是否有更高的风险.

主要方法:

一项回顾性队列研究分析了2010年至2018年的各种手术类型的66,430次手术 (全膝/关节整形,脊椎手术,CABG,切除术).
覆盖性手术被定义为至少一个小时的重叠或在一个小时以下的病例中整个持续时间.
结果包括住院死亡率,重大/轻微并发症和手术持续时间,随访直到出院.

主要成果:

与非重叠手术相比,重叠手术 (12% 的病例) 并没有显著增加住院死亡率或整体并发症率.
在重叠手术 (30分钟长) 中,手术时间显著增加.
与风险较低的患者相比,接受重叠手术的高风险患者的死亡率和并发症显著增加.

结论:

在接受常见手术的成年人中,重叠手术与死亡率或并发症率的增加无关,但与手术持续时间的延长有关.
这些发现表明,虽然整体风险可能不会增加,但在重叠手术期间,特定的高风险患者群体可能会出现不良结果.
需要进一步的研究来探索不同小组患者之间重叠手术的细微关联.

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