疾病流行病学和与年龄相关的Sigmoid volvulus手术结果的趋势:一个17年的分析分析
Lukas Schabl1,2, Stefan D Holubar3, Kamil Erozkan3
1Department for Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA. schabl.lukas@gmail.com.
Langenbeck's archives of surgery
|January 13, 2024
概括
75岁以上的老年患者面临的死亡风险显著更高,来自于西格体卷积手术,风险每年增加. 专注于年轻患者的选择性手术和尽量减少老年人的紧急手术可能会改善结果.
科学领域:
- 胃肠病学 胃肠病学
- 外科手术的结果
- 老年医学 老年医学
背景情况:
- 西格体卷发症是一种严重的胃肠道疾病,需要及时干预,以防止严重的并发症.
- 对西格体卷发的手术治疗带来了独特的挑战,特别是对老年患者来说,影响了死亡率和发病率.
- 了解随着时间的推移外科手术实践和结果的趋势对于优化护理至关重要.
研究的目的:
- 研究老年患者患有西格体卷发症所面临的手术治疗挑战,包括死亡率和发病率.
- 为了分析医疗实践的变化和患者的结果在17年的时间里,西格体卷积手术.
- 为了比较不同年龄组的治疗结果,这些年龄组接受了西格体卷的外科手术.
主要方法:
- 利用国家外科质量改进项目的数据库 (2005-2021年) 用于为结肠卷积而接受左半球切除术的患者.
- 将患者分为三个年龄组:<60岁,60-75岁和>75岁.
- 进行了调整后勤回归分析,以比较年龄组之间的死亡率,发病率和手术方法.
主要成果:
- 这项研究包括6775名患者;75岁以上的年龄组表现出更高的男性性别率,更低的BMI,更少的腹腔镜手术和更高的口腔利用率.
- 75岁以上的患者与年轻患者相比,死亡风险高5.67倍,年龄每年风险增加10%.
- 与选择性手术相比,紧急手术与较高的死亡率 (1.63倍) 和发病率 (1.30倍) 相关;死亡率在17年内下降,而腹腔镜手术增加.
结论:
- 75岁以上的患者极易受到伤害,面临着因西格体卷积手术而导致死亡率升高和年龄相关的风险.
- 为年轻人优先选择性手术,并尽量减少老年人的紧急手术,可能会减轻手术死亡率.
- 这项研究强调了需要量身定制的外科手术策略,以改善Sigmoid Volvulus的老年患者的治疗结果.
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