术前贫血优化与非心脏手术后重大并发症之间的关联:回顾性分析
Federico Almonacid-Cardenas1, Eva Rivas2, Moises Auron3
1Cleveland Clinic, Anesthesiology Institute, Department of Outcomes Research, Cleveland, USA.
Brazilian journal of anesthesiology (Elsevier)
|December 3, 2023
概括
优化手术前贫血并没有减少非心脏手术患者的重大术后并发症或死亡率. 这项研究发现,贫血优化和手术后30天内改善的患者结果之间没有显著的关联.
科学领域:
- 麻醉学 麻醉学
- 在外科手术期间的医学.
- 血液学 血液学 血液学
背景情况:
- 手术前的贫血很常见,并且与更糟糕的外科手术结果有关.
- 目前还没有证据表明,在手术前优化贫血是否会改善患者的结果.
- 这项研究研究了手术前贫血优化对术后并发症的影响.
研究的目的:
- 评估术前贫血优化和复合终点之间的关联.
- 终点包括主要的心血管,脏和肺部并发症.
- 在非心脏手术后30天内所有原因的死亡率也被评估.
主要方法:
- 对接受非心脏手术的成年患者的回顾性分析.
- 贫血定义为血红蛋白<12.0 g/dL (女性) 或<13.0 g/dL (男性) 在手术前6个月内.
- 使用基于倾向分数的概括估计方程和调解分析.
主要成果:
- 分析了5700名贫血优化和8721名非优化患者.
- 综合结局发生在21.5%的优化患者和18.0%的非优化患者中 (OR 0.99,p=0.90).
- 术内红细胞输血显示轻微调解;低血压持续时间没有调解结果.
结论:
- 术前贫血优化与复合结局的降低无关.
- 在优化贫血和重大术后并发症或死亡率之间没有发现显著的联系.
- 可能需要进一步的研究来澄清手术患者贫血管理的作用.
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