营养不良和头癌手术后的不良结果
William T Reed1, Rong Jiang2, Tetsu Ohnuma3
1Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina.
JAMA otolaryngology-- head & neck surgery
|October 26, 2023
概括
营养不良影响22.6%的头癌患者接受手术. 这种情况不成比例地影响黑人患者和医疗补助计划的患者,导致更糟糕的结果,如更长的住院时间和增加的并发症.
科学领域:
- 在瘤学瘤学.
- 外科手术的结果
- 健康差异 在健康上的差异
背景情况:
- 头癌 (HNC) 患者因癌症的位置和治疗而面临高营养不良风险.
- 营养不良与不良结果有关,但社会人口统计学因素和结果程度需要进一步研究.
研究的目的:
- 为了检查种族,种族和保险类型与HNC手术患者的外科手术期间营养不良之间的关联.
- 确定营养不良如何影响该患者群体的临床结果.
主要方法:
- 使用Premier医疗保健数据库 (2008-2020) 进行的回顾性队列研究.
- 包括接受HNC手术的成年患者,通过诊断和程序代码识别营养不良.
- 多变量后勤回归分析了人口统计,营养不良和结果之间的关联.
主要成果:
- 在13895名HNC手术患者中,22.6%患有术前营养不良.
- 与白人患者和私人保险人员相比,非西班牙裔黑人患者和医疗补助或医疗保险患者的营养不良几率更高.
- 营养不良与逗留时间的延长,成本的增加,术后肺部并发症的增加以及出院回家率的降低相关.
结论:
- 在HNC手术患者中,外科手术期间的营养不良很普遍,几乎影响了五分之一的患者.
- 存在差异,黑人患者和医疗补助受益者经历了更高的营养不良率.
- 营养不良显著加剧了住院时间,费用和术后并发症.
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