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与退伍军人的外科手术期间输血相关的因素
Kelly T Wagner1, James Alex Randall2, Fred Brody1
1Department of Surgery, Veterans Affairs Medical Center, Washington, District of Columbia, USA.
概括
高龄,男性性别,吸烟和低BMI增加了退伍军人接受非心脏手术的输血风险. 术后输血与更糟糕的结果有关,包括中风和死亡率.
科学领域:
- 麻醉学 麻醉学
- 外科手术的结果
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在民用文献中,术后输血与不良临床结果有关.
- 患者血液管理计划 (PBMP),静血剂和外科医生培训可能会减少术后出血.
- 确定退伍军人输血的术前风险因素对于有针对性的干预至关重要.
研究的目的:
- 在经历非心脏手术的退伍军人群中确定与外科手术期间输血相关的术前风险因素.
- 描述术前输血的预测因素及其与术后结果的关联.
主要方法:
- 退伍军人事务外科质量改善项目数据库的回顾性审查 (2016年4月 - 2021年3月).
- 包括18岁以上接受非心脏手术的患者.
- 单变量和多变量分析以确定外科手术期间输血的预测因素.
主要成果:
- 在6108名患者中,有153名患者接受了术后输血.
- 输血风险因素包括年龄较大,男性性别,黑人种族,吸烟和低体重指数 (BMI).
- 血管,骨科和一般手术的输血率最高. 输血增加了中风和30天死亡率的风险.
结论:
- 术后输血与非心脏手术后退伍军人的发病率和死亡率增加有关.
- 需要预测模型和PBMP来降低这一群体的输血率和并发症.
- 了解术前风险因素是制定有针对性的干预措施的基础.
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