危急病外科患者功能衰退的预测因素:国家分析
Selena J An1, Charlotte Smith2, Dylane Davis2
1Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
The Journal of surgical research
|January 28, 2024
概括
超过三分之一的重症手术患者在重症监护室 (ICU) 入院后经历功能衰退. 肺部,肌肉骨和神经外科手术显著增加这种风险,需要有针对性的康复资源.
科学领域:
- 关键护理医学 关键护理医学
- 外科手术的结果
- 患者康复 患者康复
背景情况:
- 功能衰退是严重疾病的已知并发症.
- 对入住重症监护室 (ICU) 的手术患者的具体影响仍然不充分描述.
研究的目的:
- 描述ICU入院后手术患者功能衰退的发生率和预测因素.
主要方法:
- 对2007年至2017年期间入院ICU的52,838名手术患者的回顾性分析.
- 利用236家医院的Cerner急性生理学和慢性健康评估数据库.
- 功能衰退和没有功能衰退的患者进行比较,建模衰退的预测因素.
主要成果:
- 在包括的手术ICU患者中,功能衰退发生在36.5%的患者.
- 经历衰退的患者年龄较大 (中位数为69岁与63岁),男性比例略低.
- 与心血管手术相比,肺部 (OR 6.54),肌肉骨 (OR 4.13) 和神经系统 (OR 2.67) 的手术与功能衰退的几率明显更高,在对共变量进行调整后.
结论:
- 超过三分之一的重症手术患者经历功能衰退.
- 特定的手术类型,包括肺部,肌肉骨和神经系统手术,构成最高风险.
- 对于具有功能衰退高风险的手术患者,应该优先考虑康复策略.
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