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在接受胰腺手术的患者中,手术前的营养支持会影响PREPARE评分的准确性
Pavel Skalicky1, Katerina Knapkova1, Jana Tesarikova2
1Department of Surgery I, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic.
Frontiers in surgery
|December 4, 2023
概括
手术前胰腺切除 (PREPARE) 风险评分在接受营养支持的患者预测重大并发症的准确性较低. 它在胰腺手术中用于术前风险评估的临床用途是有限的.
科学领域:
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
- 临床风险评估临床风险评估
背景情况:
- 胰腺切除带有重大术后并发症的重大风险.
- 准确的手术前风险分层对于优化患者的治疗结果至关重要.
- 术前胰腺切除 (PREPARE) 评分是为此目的而开发的一种工具.
研究的目的:
- 在接受胰腺切除的患者中验证PREPARE风险评分的预测准确性.
- 在接受标准化手术前营养支持的队列中评估PREPARE评分的表现.
主要方法:
- 一项针对216名接受胰腺切除的患者的前性研究.
- 收集人口,临床,手术和术后数据.
- 计算PREPARE分数和预测的并发症风险.
- 使用考克斯回归和C-统计学进行模型评估,分析主要并发症.
主要成果:
- 该研究包括216名患者,平均年龄为65岁;75.9%的ASA得分为II,85.6%的PREPARE得分风险低.
- 主要发病率和30天死亡率分别为11.1%和1.9%.
- 手术类型和ASA得分是并发症的重要预测因素,但PREPARE得分显示预测能力较弱 (C统计值为0.657,风险类别为0.559).
结论:
- PREPARE风险评分在预测接受持续手术前营养支持的患者主要并发症时的准确性较低.
- 这些发现表明,PREPARE评分对该患者群体的手术前临床决策有用性的局限性.
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