在经过非心脏手术后的退伍军人中进行术后输血
J Alex Randall1,2, Kelly T Wagner2, Fred Brody2
1Department of Obstetrics and Gynecology, Rochester General Hospital, Rochester, New York, USA.
概括
外科手术期间输血增加了患者的发病率和死亡率. 优化手术前的血红素水平可能会减少输血需要和相关的并发症,跨手术专业.
科学领域:
- 医学 医学 医学 医学 医学
- 手术 手术 手术 术 术
- 血液学 血液学 血液学
背景情况:
- 术后输血与患者发病率和死亡率的增加有关.
- 输血率和相关的手术变量在各外科专业之间存在差异.
研究的目的:
- 确定影响外科专业的外科手术期间输血要求的共同和独特变量.
- 分析手术前因素对输血需求和患者结果的影响.
主要方法:
- 退伍军人事务外科质量改善项目的5344名患者的回顾性审查.
- 基于术后输血 (72小时内) 的患者分层.
- 单变量和多变量分析以确定重大风险因素.
主要成果:
- 153名患者 (2.9%) 需要进行术后输血.
- 输血患者更有可能是男性,有出血障碍,并且具有更多的手术前风险因素.
- 术前血红素的升高对输血有保护作用;不同专业之间并发症没有显著差异.
结论:
- 基于专业的输血差异可能与患者人口统计学,医院门和手术复杂性有关.
- 术前血红素优化是一种潜在的策略,可以减轻输血相关的病率和成本.
- 像B12,叶酸,铁和红素补充剂这样的策略可能会改善血红素水平.
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