胃癌胃切除术后1年死亡率的预测因素
Akihiro Sekimoto1, Hideo Miyake1, Hidemasa Nagai1
1Department of Gastrointestinal Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nakamura-ku, Nagoya, Japan.
World journal of surgery
|April 30, 2024
概括
一个新的评分系统预测胃切除术后胃癌患者的1年死亡率. 该工具有助于识别需要预先护理计划 (ACP) 的患者,以获得更好的舒适性和结果.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 抚慰性护理是一种缓解性护理.
背景情况:
- 一年死亡率是指导息护理和预先护理计划 (ACP) 在无法治愈或终端疾病中的关键指标.
- 经过胃切除术的胃癌 (GC) 患者对于预测1年死亡率的确定的风险因素很少.
- 优化舒适度和预期寿命需要了解胃切除术后的死亡风险.
研究的目的:
- 确定胃切除术后胃癌患者1年死亡率的显著独立预后因素.
- 开发和验证一个评分系统 (WHO) 来预测这一患者队列的1年死亡率.
- 帮助及时转诊专家息护理和预先护理计划 (ACP).
主要方法:
- 分析了1415名经过胃切除术的胃癌患者 (I-IV阶段) 的队列.
- 患者被分为一个调查组 (n=850) 和一个验证组 (n=565).
- 多变量分析确定了关键预后因素,并开发并验证了1年死亡率得分 (WHO).
主要成果:
- 确定了7个1年生存期的独立预后因素:年龄≥78,术前并发症,全胃切除,术后并发症 (Clavien-Dindo≥3a),III/IV期和R2切除.
- 开发的1年死亡率得分 (WHO) 在不同得分值和验证组中,在预测一年内死亡时表现出不同的灵敏度和特异性.
- 验证组中的OMS3显示了91%的敏感性和66%的特异性;验证组中的OMS5显示了55%的敏感性和93%的特异性.
结论:
- 一年死亡率得分 (WHO) 为胃切除术后的胃癌患者提供了有价值的预后信息.
- 外科医生可以利用OMS来优化提前护理计划 (ACP) 讨论的时间.
- 这种工具可以通过促进及时的息干预来改善患者的舒适性和护理.
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