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手术患者之间的长期疾病相互作用:一个人口队列研究
Alexander J Fowler1, M A Hussein Wahedally2, Tom E F Abbott3
1School of Medicine and Dentistry, Queen Mary University of London, London, UK; Royal College of Surgeons of England, London, UK.
British journal of anaesthesia
|July 3, 2023
概括
多重病变影响12.8%的外科手术患者,导致一半以上的术后死亡. 了解疾病相互作用对于改善这些复杂病例的结果至关重要.
科学领域:
- 外科手术 手术手术
- 老年医学 老年医学
- 公共卫生 公共卫生
背景情况:
- 随着手术人口的老龄化,长期疾病的患病率增加.
- 多病症手术患者的结果没有得到充分的记录.
研究的目的:
- 描述多病症手术患者的结果.
- 调查多重病态对术后死亡率和再接收的影响.
主要方法:
- 在英格兰国家卫生服务 (2010-2015年) 中对成年人手术程序的分析.
- 多重发病的定义是两个或两个以上的长期疾病 (修改的查尔森指数).
- 主要结局:术后90天死亡;次要结局:90天紧急再入院.
主要成果:
- 在2019万个手术术中的12.8%中存在多重病情.
- 多病症患者的90天死亡率 (7.6%与0.9%) 和再入院率 (22.0%与7.2%) 较高.
- 多种疾病占所有手术后死亡的50%以上,无论是选择性还是非选择性手术.
结论:
- 多重病变是外科手术结果的一个重要因素,影响近13%的患者.
- 多病症患者代表了手术后死亡率和再入院的不成比例的高负担.
- 多病症患者的疾病相互作用极大地影响患者的治疗结果.
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