定义了八十岁的八十岁人中手术风险,他们接受了对食道的修复
Hadley H Wilson1, Sullivan A Ayuso1, Mikayla Rose1
1Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive Suite 300, Charlotte, NC, 28204, USA.
Surgical endoscopy
|July 26, 2023
概括
八十多岁人群的副食道修复 (PEHR) 结果显示,非选择性手术的增加和更高的再接收率. 虽然不是死亡率的独立预测指标,但在仔细的风险评估下,80岁以上人群的选择性PEHR是可行的.
科学领域:
- 老年人手术是一门老年手术.
- 手术结果研究研究.
- 胃肠道手术 胃肠道手术
背景情况:
- 人口老龄化增加了老年患者手术干预的相关性.
- 经过准食道修复 (PEHR) 的八代人 (80岁及以上的患者) 需要具体的结果分析.
- 了解PEHR在这个人群中的风险和益处对于临床决策至关重要.
研究的目的:
- 为了比较经过PEHR的八十多岁患者的结果与年轻患者 (18-79岁) 的结果.
- 分析选择性与非选择性PEHR对八十岁人的结果的影响.
- 在老年患者中确定PEHR后死亡率和再入院的预测因素.
主要方法:
- 利用全国再接收数据库 (2016-2018) 对接受PEHR的18岁以上患者.
- 排除了患有胃肠道恶性瘤或并发性减肥手术的患者.
- 八十岁生 (≥80岁) 和非八十岁生 (18-79岁) 的结果比较,包括选择性和非选择性程序的子组分析.
主要成果:
- 在46450名PEHR患者中,八代人占11.7%,并且更有可能进行非选择性手术 (46.3%与18.2%相比).
- 非选择性PEHR与较高的死亡率相关 (5.5%对1.2%).
- 与非八十岁人相比,八十岁人的选择性PEHR显示出更高的死亡率 (1.3%与0.2%相比),更长的LOS,以及30天再入院的增加,尽管八十岁人的身份不是死亡率的独立预测因素.
结论:
- 接受PEHR的八代人更容易接受非选择性手术,这显著增加了死亡风险.
- 虽然80多岁的选用PEHR比非选用程序产生更好的结果,但他们的发病率和死亡率仍然高于年轻的同行.
- 选择性PEHR是八十岁的可行选择,需要在手术前进行全面的风险效益评估.
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