脆弱性是内镜鼻手术后术后救援药物使用的独立预测因素
Kolin E Rubel1, Andrea Lopez2, Rory J Lubner2
1Department of Otolaryngology-Head and Neck Surgery, University of Minnesota Medical Center, Minneapolis, Minnesota, USA.
International forum of allergy & rhinology
|January 25, 2024
概括
修改后的脆弱指数 (mFI-5) 预测在内镜鼻手术 (ESS) 后,救援抗生素,类固醇和灌的需求更高. 较高的脆弱性得分表明ESS患者手术后不良结果的风险增加.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 老年医学 老年医学
- 手术结果研究研究.
背景情况:
- 修改后的五项脆弱性指数 (mFI-5) 是用于预测不良外科手术结果的有效工具.
- 不健康的衰老在手术患者群体中是一个日益关注的问题.
- 透镜鼻手术 (ESS) 的结果可能会受到患者健康状况的影响.
研究的目的:
- 评估修改后的五项脆弱指数 (mFI-5) 与经过ESS患者的术后结果之间的关联.
- 确定脆弱性是否预测了在ESS之后需要术后药物和干预措施的需要.
- 评估mFI-5作为ESS背景下的风险分层工具的实用性.
主要方法:
- 在2014年至2018年间,对403名接受ESS治疗的患者进行了回顾性审查.
- 基于五个关键的并发症计算的mFI-5.
- 多变量回归分析,以评估mFI-5得分与术后救援药物使用 (抗生素,口服皮质类固醇) 和一年内抗生素灌的相关性.
主要成果:
- 增加mFI-5得分与术后更高的救援抗生素使用 (p < 0.0001),口服皮质类固醇 (p = 0.032) 和抗生素灌 (p < 0.0001) 显著相关.
- 在调整年龄,息肉状况,手术前SNOT-22得分和修复手术状态后,脆弱性得分仍然是这些结果的独立预测因素.
- 很高比例的患者需要进行干预,77%的救援抗生素,60%的口服皮质类固醇和8%的抗生素灌在六个月内.
结论:
- 修改后的脆弱指数 (mFI-5) 可以作为一个有价值的临床工具,用于预测在内镜鼻手术后需要术后救援药物的使用.
- 在手术前确定脆弱的患者可以帮助预测和管理ESS后的潜在不良结果.
- 脆弱性评估可以提高风险分层,并为ESS患者个性化术后护理计划.
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