老年患者胆管切除术后常见胆道结石的复发:风险因素分析和临床预测模型的开发
Han Wang1, Yu-Qi He1, Shi-Yang Dong1
1Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
Frontiers in medicine
|November 8, 2023
概括
手术后老年患者常见胆道结石 (CBDS) 的复发与先前胆囊切除术和较高白细胞计数等因素有关. 一个新的模型预测了复发,有助于CBDS患者的预后.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 老年医学 老年医学
背景情况:
- 胆道结石 (CBDS) 在老年患者中在胆道结石切除术后复发的情况尚不清楚.
- 识别风险因素对于预测和潜在地防止CBDS复发在这个人口群体中至关重要.
研究的目的:
- 为了确定与胆道结石复发相关的独立风险因素 (CBDS) 在胆道结石切除术后的老年患者.
- 在这个患者群体中开发和验证CBDS复发的预测模型.
主要方法:
- 对706名被诊断患有CBDS的老年患者 (≥65岁) 的回顾性分析.
- 统计分析,包括多变量考克斯回归,以确定复发的风险因素.
- 使用协同指数 (C指数) 开发和验证预测模型和名ogram.
主要成果:
- CBDS的复发率为8.8% (62/706名患者).
- 确定的独立风险因素包括:先前的胆囊切除术,白细胞 (WBC) 数量升高 (≥11.0 × 109/L),高的手术前总 bilirubin (TBIL) 水平 (≥36.5 mmol/L),多块石头 (≥2),最大石头直径更大 (≥0.85 cm) 和T管排水.
- 开发的预测模型表现出良好的预测能力,C指数为0.758.
结论:
- 在老年患者中,特定的临床和实验室发现是CBDS复发的显著预测因素.
- 已建立的预测模型为评估CBDS复发风险和指导患者管理提供了有价值的工具.
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