精神病学诊断与接受大结直肠手术的患者的术后差异有关
Alexis A Webber1, Shruthi Perati2, Emily M Su3
1General Surgery Resident, Albany Medical Center, Albany, NY, USA.
The American surgeon
|April 23, 2024
概括
患有精神病诊断 (PD) 的患者在结直肠手术后面临更高的并发症风险,包括感染和重新手术. 这些发现凸显了在外科手术前期需要加强心理健康支持,以改善外科手术结果.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 精神病的并发症 精神病的并发症
- 外科手术的结果
背景情况:
- 超过50%的住院患者有并发性精神病诊断 (PD).
- PD增加了发病风险,包括更长的住院时间和死亡率.
- 对于患有PD的患者,结直肠手术结果的数据有限.
研究的目的:
- 为了比较患有PD和没有PD,接受大结直肠手术的患者的术后结果.
- 在结直肠外科手术患者中确定与PD相关的特定风险.
主要方法:
- 对单一机构的国家外科质量改善计划 (2013-2019) 的分析.
- 包括主要的结直肠手术.
- 患有PD和没有PD的患者之间的结局比较,重点是长期停留 (pLOS) 和30天再入院.
主要成果:
- 在1447名患者中,有402名 (27.8%) 患有PD.
- 患有PD的患者吸烟率和BMI都更高.
- 在PD组中,手术部位感染 (SSI) 增加 (10.2%对6.12%) 和重复手术 (9.45%对6.35%).
- 多变量分析证实PD是重新手术 (OR 1.53) 和SSI (OR 1.82) 的风险因素.
结论:
- 精神病诊断是结直肠手术后不良结果的重要风险因素.
- 在PD患者中观察到手术部位感染和重新手术的可能性增加.
- 需要进一步的研究来探索外科手术前精神健康支持服务的好处.
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