预测成年脊柱形手术后的主要并发症和排泄处置
Amar S Vadhera1, Rahul Sachdev1, Nicholas S Andrade1
1Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, MD 21287.
概括
西雅图脊柱评分 (SSS) 和修改后的5项脆弱性指数 (mFI-5) 在成年脊柱形 (ASD) 手术患者中比查尔森并发症指数 (CCI) 或成年脊柱形-并发症评分 (ASD-CS) 更好地预测并发症和出院倾向.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 整形外科 整形外科 整形外科
- 医学并发症评估
背景情况:
- 风险分层对于接受侵袭性脊柱手术的患者至关重要.
- 现有的并发症指数,如查尔森并发症指数 (CCI),对于成年脊柱形 (ASD) 患者缺乏脊柱特异性.
研究的目的:
- 为了比较西雅图脊柱评分 (SSS),成人脊柱形-并发症评分 (ASD-CS) 和修改的5项脆弱性指数 (mFI-5) 与CCI的预测准确度.
- 为了确定哪个指数最好地预测ASD手术后的重大外科手术后并发症和放出处置.
主要方法:
- 对164名经过脊柱关节切除 (≥4级) 的成年脊柱形患者的回顾性审查.
- 后勤回归模型评估了CCI,SSS,ASD-CS和mFI-5对重大并发症和出院处置的预测能力.
- 模型匹配使用伪R2和Akaike信息标准 (AIC) 进行了比较.
主要成果:
- 19%的患者经历了严重的术后并发症,42%的患者被送往住院康复.
- 西雅图脊柱评分 (SSS) 在并发症和出院处置方面表现出最高的预测准确性.
- 修改后的5项脆弱性指数 (mFI-5) 显示出类似的预测能力,而CCI和ASD-CS则是较弱的预测指标.
结论:
- 西雅图脊柱评分 (SSS) 和修改后的5项脆弱性指数 (mFI-5) 与查尔森共发性指数 (CCI) 和成人脊柱共发性-共发性评分 (ASD-CS) 相比,在成年脊柱形手术中,它们是优异的预测结果.
- 建议在ASD患者的临床风险分层和结果研究中使用SSS和mFI-5.
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