在紧急胸部手术条件下,脆弱性与90天死亡率有关
Jacqueline Kloos1, Aria Bassiri2, Vanessa P Ho3
1Case Western Reserve University School of Medicine, Cleveland, Ohio.
JTCVS open
|February 29, 2024
概括
脆弱性显著增加了紧急胸部手术 (UTS) 患者的90天死亡风险. 脆弱性对死亡率的影响因特定的UTS条件和脆弱性严重程度而异,这突显了其在风险评估中的重要性.
科学领域:
- 胸部外科手术 胸部外科手术
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 脆弱性与选择性胸部手术的不良结果有关.
- 脆弱性对紧急胸部手术 (UTS) 结果的影响尚不清楚.
研究的目的:
- 量化虚弱对紧急胸部手术条件的患者90天死亡率的影响.
- 为了比较虚弱对UTS死亡率的影响与其对选择性胸部手术结果的影响.
主要方法:
- 从国家再接收数据库分析了107,487名入院患有UTS疾病的患者 (2017年1月至9月).
- 使用赤字积累方法评估脆弱性;90天内的死亡是主要结果.
- 根据考克斯的比例危险模型,调整了人口和医院因素.
主要成果:
- 在所有UTS疾病中,增加的脆弱性与90天死亡率的增加显著相关 (HR,2270;P<.001).
- 脆弱性对死亡率的影响的大小因UTS疾病类型和脆弱性水平而异.
- 脆弱性在所有诊断中都显示出死亡率增加的趋势,与接受选择性脑膜切除术的非脆弱患者相比.
结论:
- 脆弱性在紧急胸部手术中显著影响90天的死亡率,影响因疾病和脆弱性的严重程度而异.
- 这些发现强调了脆弱性评估对于紧急胸部手术中的风险分层的重要性.
- 脆弱性评估可以提高UTS患者的临床决策和行政风险评估.
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