脆弱与衰老之间的关联:来自一项包括9497名老年患者在内的观察性研究的结果
Liva Thoft Jensen1, Lars Lundstrøm2,3, Ana Kowark4
1Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Acta anaesthesiologica Scandinavica
|November 21, 2023
概括
90岁及以上的老年手术患者的虚弱患病率明显高于80-89岁患者. 虚弱,而不是老年本身,与这一群体的30天死亡风险增加有关.
科学领域:
- 老年医学 老年医学
- 外科手术的结果
- 公共卫生 公共卫生
背景情况:
- 老年手术患者面临手术后并发症的风险较高.
- 老年人的健康和功能状况存在显著的变化.
- 识别脆弱性对于在老年人中选择合适的外科候选人至关重要.
研究的目的:
- 为了比较90岁及以上的手术患者和80-89岁的手术患者的虚弱率.
- 评估老年手术患者的脆弱性和全因30天死亡率之间的关联.
主要方法:
- 在老年人 (POSE) 数据库中对临床干预结果研究的二次分析.
- 包括来自177个欧洲中心的9497名患者 (≥80岁).
- 脆弱性被评估为二进制变量;使用逻辑回归分析的死亡率,调整为共变量.
主要成果:
- 与80-89岁 (12.5%) 的患者相比,90岁以上的患者有较高的虚弱率 (27.4%).
- 虚弱与30天死亡率的增加显著相关 (调整后OR为4.5).
- 在调整后的分析中,高级年龄 (≥90岁) 与30天死亡率没有独立相关.
结论:
- 在老年人 (≥90岁) 手术群体中存在高频率的脆弱性.
- 虚弱是老年手术患者30天死亡率增加的一个关键预测因素.
- 单独的年龄并不是死亡风险的主要驱动因素;脆弱性是一个更重要的因素.
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