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术前脱水预测了前椎间盘切除和融合后的不良事件
Abdullah Ghali1, Gautham Prabhakar2, David Momtaz2
1Department of Orthopedics, Baylor College of Medicine, Houston, TX, USA ghaliabdullah@gmail.com.
International journal of spine surgery
|September 28, 2023
概括
在接受前椎切除和融合 (ACDF) 手术的患者中,术前脱水是常见的. 这种情况增加了术后并发症的风险,并延长了住院时间,突出了需要评估水分状态的必要性.
科学领域:
- 神经外科 神经外科
- 整形外科手术 整形外科手术
- 患者的治疗结果.
背景情况:
- 前椎切除和融合 (ACDF) 是常见的关节炎手术.
- 术前脱水是造成手术不良结果的潜在危险因素,尽管其对ACDF的影响仍在争论中.
- 现有的文献提出了相互矛盾的证据,关于手术前脱水和手术后的结果在各种手术环境之间的关联.
研究的目的:
- 在接受ACDF的患者中调查术前脱水和30天术后不良事件之间的关系.
- 确定手术前脱水是否与ACDF后住院时间的延长有关.
- 评估手术前水分状态评估对ACDF患者风险分层的有用性.
主要方法:
- 从美国外科医生学院国家外科质量改进计划数据库对2015年至2020年期间接受ACDF的14932名患者的回顾性分析.
- 不包括急性创伤患者.
- 由手术前血尿素与肌素比率>20定义的脱水;使用多变量回归分析对脱水和非脱水队列之间的术后结果进行比较.
主要成果:
- 28.1%的ACDF患者在手术前脱水.
- 脱水患者的伤口,血液和肺部并发症以及Clavien-Dindo IV级事件的几率显著增加.
- 脱水与逗留时间延长 (平均增加0.5天) 和退院回家的可能性降低有关.
结论:
- 术前脱水在ACDF患者中很普遍,并且与术后并发症增加和延长住院时间显著相关.
- 通过使用标准实验室指标进行手术前水分状态的例行评估,可以帮助风险分层.
- 评估水分状态可以为患者咨询和ACDF手术的手术时间提供信息.
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