在接受低,中等或重大非心脏手术的老年患者中,术后结果,长期死亡率和时间趋势
E K M Tjeertes1,2, T F W Simoncelli1, A J M van den Enden1
1Department of Anesthesiology, Erasmus MC University Medical Center, PO BOX 2040, 3000 CA, Rotterdam, The Netherlands.
Aging clinical and experimental research
|March 11, 2024
概括
老年患者 (80岁以上) 可以从非心脏手术中获益,但仅仅年龄并不是拒绝手术的理由. 即使是低风险的手术也有很高的死亡率,需要个性化风险评估和以患者为中心的护理.
科学领域:
- 老年人手术是一门老年手术.
- 手术结果研究研究.
- 患者风险分层患者风险分层
背景情况:
- 在老年患者 (80岁以上) 中评估手术益处是具有挑战性的.
- 八十多岁的非心脏手术需要仔细考虑风险和益处.
研究的目的:
- 调查80岁及以上患者非心脏手术的特征和结果.
- 分析住院时间,出院目的地,以及这一人口群中的死亡率.
主要方法:
- 在2004-2017年间,对8251名住院患者 (80岁以上) 进行了非心脏手术的观察性研究.
- 对结局的分析,包括停留时间和30天/长期死亡率.
- 风险分层分为低风险,中风险和高风险的外科手术子组.
主要成果:
- 住宿的中位长度因风险组而异 (低风险3天至高风险10天).
- 在整个研究期间,整体30天死亡率一直很高 (6.7%).
- 停留时间显示,随着时间的推移,停留时间呈下降趋势.
结论:
- 年龄本身不应该阻止老年患者接受必要的手术.
- 实质性的30天死亡率 (超过2%) 存在,即使在80多岁的低风险手术.
- 对老年人进行手术的决定必须整合个人风险评估,患者偏好和以患者为中心的规划.
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