术后急性缺血性中风的危险因素:先前曾经进行过非心脏手术的中风的老年患者:一项回顾性队列研究
Wei Xiao1, Shuyi Yang2, Shuai Feng1
1Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
BMC surgery
|August 29, 2023
概括
在非心脏手术后,先前患有中风的老年患者 (≥75岁) 面临术后急性缺血性中风 (PAIS) 的风险增加. 动脉内关节切除术,更长的手术持续时间和更高的手术前残疾预测PAIS的发展.
科学领域:
- 神经学 神经学
- 老年医学 老年医学
- 外科手术的结果
背景情况:
- 手术后急性缺血性中风 (PAIS) 是老年患者中患有中风史且接受非心脏手术的一个重大问题.
- 确定PAIS的发病率和风险因素对于改善患者的治疗结果至关重要.
研究的目的:
- 为了调查PAIS的发病率和风险因素,在老年患者 (≥75岁) 中,有史以来非心脏手术的缺血性中风.
- 确定PAIS的预测因素及其对患者结果的影响.
主要方法:
- 一个单一中心的回顾性队列研究包括在2019年1月1日至2022年4月30日期间接受非心脏手术的老年患者 (≥75岁).
- 从电子医疗记录中提取数据,并使用多变量后勤回归来确定PAIS预测因素和结果决定因素.
主要成果:
- 在400名患者中,PAIS的发病率为6.0% (24名).
- 显著的PAIS预测因素包括心动脉内关节切除术 (CEA),更长的手术持续时间,以及手术前修改的兰金度表 (mRS) 评分≥3.3.
- CEA增加了PAIS风险 (OR4.14),每一分钟的手术增加了风险 (OR1.01),mRS ≥3增加了几率 (OR4.09).
结论:
- 中心心肺炎,长期手术和手术前功能状态 (mRS ≥3) 是PAIS在这个脆弱人群中的关键风险因素.
- PAIS与住院死亡率增加和住院时间延长有关,这凸显了针对性预防策略的必要性.
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