在一级或两级ACDF患者中,从门诊转移到住院的意外转换的危险因素
Soji Tani1,2, Ichiro Okano2, Yusuke Dodo2
1Spine Care Institute, Hospital for Special Surgery, New York, NY.
Spine
|June 30, 2023
概括
女性患者,较低的BMI和较高的ASA分数增加了将外科医院前椎切除和融合 (ACDF) 转换为住院护理的风险. 疼痛管理是转化的主要原因,突出了潜在干预的领域.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 整形外科 整形外科 整形外科
- 健行护理服务提供者
背景情况:
- 越来越多的门诊手术的趋势是为了管理医疗保健成本和提高患者满意度.
- 前椎切除和融合 (ACDF) 是一种常见的门诊脊柱手术.
- 对导致ACDF患者住院转换的风险因素的理解有限.
研究的目的:
- 为了确定与患者状态转换从门诊到住院的ACDF相关的因素.
- 分析ACDF患者的人口统计,手术和并发症相关数据.
主要方法:
- 在2016-2021年期间,对662名接受一级或两级ACDF的患者进行了回顾性观察性研究.
- 基于人口统计学,手术细节,并发症和转换原因的门诊与住院 (停留时间>48h) 组的比较.
- 多变量后勤回归用于确定住院患者转换的独立风险因素.
主要成果:
- 25.4%的患者转换为住院病人的身份.
- 转换的独立风险因素包括女性性别,BMI <25,ASA ≥3,更长的手术时间,更高的血液损失,上层手术,双层融合,晚期开始时间和高的术后疼痛.
- 疼痛管理 (80.0%) 是最常见的转化原因; 1.5% 经历了需要重新输管的呼吸道并发症.
结论:
- 确定了几个独立的风险因素,导致长时间住院后的流动性 ACDF.
- 诸如手术持续时间,开始时间和血液损失等可变因素提供了干预机会.
- 外科医生必须保持警,以防 ambulatory ACDF患者的潜在气道并发症.
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