在接受慢性脏替代疗法的患者中,胃肠道手术后的术后结果:基于人口的队列研究
Dharmenaan Palamuthusingam1,2,3, Carmel M Hawley2,4,5, Elaine M Pascoe6
1Metro North Kidney Service, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland, Australia.
Annals of surgery
|December 12, 2023
概括
慢性脏替代疗法 (KRT) 患者的胃肠道 (GI) 手术率很高. 腹腔透析 (PD) 患者面临高的术后死亡率,特别是紧急手术.
科学领域:
- 科和外科的结果.
- 胃肠道外科 流行病学
- 慢性病管理 慢性病管理
背景情况:
- 慢性脏替代疗法 (KRT) 的患者接受更高的整体手术率.
- 关于KRT患者的胃肠道 (GI) 手术类型和结果的当代数据有限.
- 慢性透析包括慢性透析 (血液透析,腹腔透析) 或长期功能移植.
研究的目的:
- 评估慢性脏替代疗法 (KRT) 患者在各种胃肠道 (GI) 手术后的术后死亡率和发病率.
- 在15年的时间内,分析不同KRT模式的胃肠道手术率和结果.
主要方法:
- 链接澳大利亚和新西兰透析和移植 (ANZDATA) 注册数据与住院数据集 (2000-2015).
- 根据KRT方式 (血液透析,腹腔透析,家庭血液透析,移植) 和胃肠道手术类型对患者进行分类.
- 分析了手术率 (Poisson模型) 和30天/住院术后死亡/发病风险 (逻辑回归).
主要成果:
- 在9116名慢性KRT患者身上进行了14540次胃肠道手术.
- 腹腔透析 (PD) 患者的胃肠道手术率最高,以及30天术后死亡风险最大,特别是在紧急手术后.
- 感染性并发症比心脏并发症更频繁;观察到BMI和死亡率之间存在U形关联.
结论:
- 慢性KRT患者的胃肠道手术和相关发病率很高.
- 腹腔透析 (PD) 患者,老年人和体重不足或中度肥胖的人面临更高的风险.
- 这些发现凸显了在KRT群体中需要谨慎的手术管理和风险分层的需要.
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