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甲状腺风暴的运营管理中的国家趋势和结果
Young-Ji Seo1, Nikhil Chervu1,2, Peyman Benharash2
1Department of Surgery, University of California-Los Angeles, Los Angeles, CA, USA.
甲状腺风暴的发生率和死亡率正在上升. 甲状腺风暴的甲状腺切除术不常见,并发症率为30%,并不会影响死亡率,尽管心脏和功能衰竭增加了手术的可能性.
科学领域:
- 内分泌学 在内分泌学.
- 手术重症监护手术重症监护
- 医疗保健服务研究 医疗服务研究
背景情况:
- 甲状腺风暴是一种严重的甲状腺毒的表现,手术管理的结果不清楚.
- 目前的指导方针有利于非手术治疗,但手术是耐火病例的选择.
研究的目的:
- 为了评估甲状腺切除术在患有甲状腺风暴的患者的结果.
- 为了确定与手术干预和甲状腺风暴入院的死亡率相关的因素.
主要方法:
- 全国住院患者样本 (2016-2020年) 的回顾性分析.
- 包括诊断为甲状腺风暴的患者.
- 多变量后勤回归用于评估手术和死亡率的预测因素.
主要成果:
- 估计有16,175例甲状腺风暴病例发生,发病率和死亡率增加 (2.9%至5.3%).
- 甲状腺切除术在3.9%的病例中进行,术后并发症率为30%.
- 急性脱补偿性心力衰竭和急性功能衰竭与手术的几率增加有关,但甲状腺切除术与死亡率没有显著关联.
结论:
- 甲状腺风暴发生率和死亡率从2016年到2020年增加.
- 甲状腺风暴的甲状腺切除术是罕见的,并发症率很高,并没有改善死亡率.
- 心脏和功能衰竭等并发症预示着甲状腺风暴的手术干预.
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