在已知或疑似COPD患者的手术前肺风险评估中进行爬楼梯测试或自我报告的功能能力-一项前性观察性研究
André Dankert1, Benedikt Neumann-Schirmbeck1, Thorsten Dohrmann1
1Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
Journal of clinical medicine
|July 14, 2023
概括
自我报告的功能能力低下 (SRPFC) 有效地预测了COPD患者手术后肺部并发症 (PPC). 在这种人群中预测PPC不需要手术前的爬楼梯测试 (SCT).
科学领域:
- 肺部医学 肺部医学
- 手术风险评估手术风险评估
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 预测术后肺部并发症 (PPC) 对慢性阻塞性肺部疾病 (COPD) 患者至关重要.
- 术前功能能力评估有助于在大型非心脏手术的风险分层.
研究的目的:
- 为了比较手术前爬楼梯测试 (SCT) 与自我报告的PPC功能能力低下 (SRPFC) 的预测准确性,在经历重大非心脏手术的已知或疑似COPD患者中进行PPC.
主要方法:
- 一项前性研究包括320名患者 (240名COPD患者,80名GOLD指标).
- 患者接受了手术前的SRPFC和SCT评估.
- 分析使用了最小绝对收缩和选择运算符 (LASSO) 回归和多变量回归模型.
主要成果:
- 在爬楼梯的变量中,LASSO专门选择了SRPFC.
- 两种SRPFC和SCT模型都显示出类似的预测性能 (AUC 0.71).
- SRPFC是PPC的一个独立风险因素 (OR 5.45),而SCTPFC不是 (OR 3.78).
结论:
- 术前SRPFC是已知或疑似COPD患者中PPC的足够预测因素.
- 额外的手术前SCT是不可或缺的,以预测PPC在这个患者群体.
相关概念视频
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
2.5K
Assessing and diagnosing Chronic Obstructive Pulmonary Disease (COPD) involves a detailed approach that includes a comprehensive review of medical history, physical examination, and a variety of diagnostic tests. This thorough evaluation is essential to ensure an accurate diagnosis and guide effective management strategies.
Medical History
Medical History
2.5K
01:25Pulmonary Function Tests
374
Pulmonary Function Tests (PFTs)
Pulmonary Function Tests are crucial diagnostic tools for assessing respiratory function, particularly in patients with chronic respiratory disorders. They comprehensively evaluate lung volumes, ventilatory function, breathing mechanics, diffusion, and gas exchange. These tests help diagnose pulmonary diseases and play a significant role in monitoring disease progression, evaluating disability, and assessing response to therapy.
PFTs involve using a spirometer, a...
Pulmonary Function Tests are crucial diagnostic tools for assessing respiratory function, particularly in patients with chronic respiratory disorders. They comprehensively evaluate lung volumes, ventilatory function, breathing mechanics, diffusion, and gas exchange. These tests help diagnose pulmonary diseases and play a significant role in monitoring disease progression, evaluating disability, and assessing response to therapy.
PFTs involve using a spirometer, a...
374
01:20Chronic Obstructive Pulmonary Disease-I: Introduction
2.8K
Chronic Obstructive Pulmonary Disease (COPD) is a long-lasting respiratory condition requiring continuous attention and care. It is a progressive lung disease that leads to breathing challenges due to airflow obstruction. It manifests as persistent respiratory symptoms and restricted airflow resulting from abnormalities in the airways and alveoli, usually due to long-term exposure to harmful particles or gases. COPD mainly consists of two primary conditions: emphysema and chronic bronchitis.
2.8K
01:30Chronic Obstructive Pulmonary Disease-V: Nursing Management
4.0K
Nursing management of Chronic Obstructive Pulmonary Disease (COPD) is crucial for providing thorough care and support to patients. Nurses play an integral role in this process through detailed assessment, careful planning, targeted interventions, and ongoing evaluation. Here's an overview of the critical steps in nursing management for COPD.
Assessment
Assessment
4.0K
01:28Physical Assessment of the Respiratory Tract I: Health History
277
Physical assessment of the respiratory tract is critical to patient care. It allows healthcare professionals to identify and manage various respiratory conditions. The process involves a combination of subjective and objective data collection.
Subjective Data
Subjective data provides vital information about the patient's health history and symptoms. This data is typically collected through interviews in which patients describe their experiences, symptoms, and concerns.
Health history and...
Subjective Data
Subjective data provides vital information about the patient's health history and symptoms. This data is typically collected through interviews in which patients describe their experiences, symptoms, and concerns.
Health history and...
277
01:23Assessment of Respiration
1.2K
The respiratory system's basic structures and primary functions lay the foundation for nurses' comprehensive respiratory assessments. This assessment includes subjective and objective data to gauge the patient's respiratory health.
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
1.2K