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功能状态对30天资源利用和指数减肥手术后器官系统并发症的影响:一个队列研究
Z Logan Holley1, Ziyad O Knio2, Long-Quan Pham1
1School of Medicine, University of Virginia.
International journal of surgery (London, England)
|September 27, 2023
概括
患有依赖性功能状态的患者在减肥手术后面临更高的非计划资源使用和感染风险. 这种增加的风险不仅仅是由于现有的医疗条件.
科学领域:
- 手术结果研究研究.
- 患者风险分层患者风险分层
- 医疗保健资源管理 医疗保健资源管理
背景情况:
- 腹部外科手术虽然是可选的,但存在固有的风险.
- 并发症的危险因素往往仅限于医疗并发症.
- 患者的功能状态对手术结果的影响需要进一步研究.
研究的目的:
- 评估手术前功能状况对腹手术后资源利用的影响.
- 评估功能状态和器官系统并发症之间的关系.
- 确定功能状态是否独立预测医疗并发症以外的不良结果.
主要方法:
- 对65627名接受减肥手术的患者 (2015-2019) 的回顾性队列研究.
- 主要独立变量:患者的功能状态.
- 主要结果:计划外的资源利用;次要结果:器官系统并发症和死亡率.
主要成果:
- 在单变量分析中,依赖性功能状态与计划外资源利用 (RR 2.98) 和血液学/传染性并发症 (RR 2.86) 有显著的相关性.
- 生存分析证实,依赖性功能状态的患者的这些事件发生的时间较短 (P < 0.001).
- 多变量分析确定了依赖性功能状态作为计划外资源利用 (aOR 2.17) 和血液/感染并发症 (aOR 2.20) 的独立预测因素.
结论:
- 依赖性功能状态是增加资源利用率和减肥手术后的血液/传染性并发症的重要危险因素.
- 这些与功能状态相关的高风险即使在考虑了医疗并发症后也会持续存在.
- 术前对功能状况的评估对于识别接受减肥手术的高风险患者至关重要.
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