结合螺旋计和ARISCAT呼吸风险评估,可以改善手术后的结果,降低墨西哥的死亡风险
Yolanda Mares-Gutiérrez1,2, Adrián Martínez-González3, Guillermo Salinas-Escudero4
1Pulmonary Physiology Department, Hospital General de México Dr. Eduardo Liceaga, C.P. 06720 Mexico City, Mexico.
术前螺旋计与ARISCAT风险评估相结合,可显著降低手术后的并发症和手术患者的死亡率. 指导方针应包括对中度至高风险个体的螺旋计.
科学领域:
- 麻醉学 麻醉学
- 肺部病理学 肺部病理学
- 手术风险评估手术风险评估
背景情况:
- 目前墨西哥的指导方针仅限于已知肺部疾病的患者进行手术前的螺旋计.
- 术前评估旨在识别风险并改善外科手术的结果.
- 加泰罗尼亚外科手术患者呼吸风险评估 (ARISCAT) 工具对手术风险进行分层.
研究的目的:
- 为了比较手术后并发症 (POC),死亡率和患有或没有接受手术前螺旋计的患者的风险因素.
- 根据ARISCAT风险水平评估螺旋计的影响.
主要方法:
- 在墨西哥总医院对2059名患者 (2013-2017) 进行了观察性,回顾性,比较性研究.
- 患者分为ARISCAT与螺旋计 (n=1306) 和ARISCAT没有螺旋计 (n=753) 组.
- 统计分析包括千平方,费舍尔的精确测试,学生的t测试和后勤回归.
主要成果:
- 螺旋测量组的POC为11%,而非螺旋测量组的POC为48%.
- 没有螺旋计的高风险患者死亡率为18%,与螺旋计的0.4%相比.
- 后勤回归证实,省略螺旋计增加了POC和死亡风险.
结论:
- 与ARISCAT评估相结合的术前螺旋计与较低的POC和死亡率有关.
- 墨西哥的临床指南应该考虑为中度和高风险的ARISCAT患者推手术前的螺旋计.
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