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慢性脱水和年龄在全肩关节整形术后术后并发症的累积影响
Matthew Kim1, Nicholas Tsouris2, Brandon E Lung3
1Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.
术前脱水会增加接受全肩关节整形手术 (TSA) 的患者的风险. 严重脱水与更高的并发症率,死亡率和更长的住院时间有关,强调需要优化水分.
科学领域:
- 整形外科手术 整形外科手术
- 腎臟病學 (nephrology) 是一種醫學.
- 老年医学 老年医学
背景情况:
- 脱水是影响手术结果的重要,可修改的危险因素.
- 在手术前优化患者的水分是最小化不良事件的关键.
- 脱水对全肩关节整形术 (TSA) 并发症的具体影响需要进一步阐明.
研究的目的:
- 调查手术前脱水水平与TSA后的术后并发症之间的关联.
- 确定与TSA患者不同程度脱水相关的特定并发症.
- 评估脱水在老年TSA患者中的作用.
主要方法:
- 使用了美国外科医生学院国家外科质量改进计划数据库 (2015-2019).
- 包括16993名接受TSA的患者,根据血液尿素/肌素 (BUN/Cr) 比率分类为非脱水,中度脱水和严重脱水组.
- 对老年患者 (>65岁) 进行多变量逻辑回归和子组分析.
主要成果:
- 严重脱水的患者表现出术后输血,死亡率,非家庭出院和长时间停留 (LOS) 的风险增加.
- 适度脱水的患者患伤口衰变的风险更高.
- 严重脱水的老年患者面临心脏并发症,输血,死亡率,非家庭出院和LOS的更大风险;老年人的中度脱水与输血和非家庭出院风险增加有关.
结论:
- BUN/Cr比率作为一个有价值的手术前指标,用于识别患有脱水风险的患者.
- 优化手术前的水分是预防TSA并发症,降低医疗保健成本和改善患者出院计划的必要条件.
- 在手术前解决脱水问题可以显著提高患者的治疗结果和TSA手术中的资源利用率.
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