在小肠阻塞的老年患者手术的时间:关于脆弱性的洞察力
Renxi Li1, Megan T Quintana, Juliet Lee
1From the George Washington University School of Medicine and Health Sciences (R.L.); and Department of Surgery (M.T.Q., J.L., B.S., S.K.), The George Washington University Hospital, Washington, District of Columbia.
接受小肠阻塞 (SBO) 手术的老年脆弱患者面临更高的死亡率. 对SBO手术的最佳时机至关重要:对于非脆弱的老年患者,在2天内,对于脆弱的老年患者,在4天内.
科学领域:
- 手术 手术 手术 术 术
- 老年病的医生 老年病的医生
- 胃肠病学 胃肠病学
背景情况:
- 小肠阻塞 (SBO) 通常需要紧急手术.
- 脆弱性和年龄对SBO手术结果的影响尚未完全理解.
- 这项研究调查了年龄和脆弱性对SBO手术结果的影响.
研究的目的:
- 根据患者的年龄和脆弱性,评估SBO手术的术后结果.
- 为了确定SBO的老年和/或脆弱患者手术的最佳时间.
主要方法:
- 来自美国外科医生学院国家外科质量改进计划数据库 (2005-2021) 的49,344次SBO手术的分析.
- 老年人 (≥65岁) 和虚弱 (5因素修改的虚弱指数≥2) 的定义.
- 多变量逻辑回归用于比较30天的术后结果.
主要成果:
- 老年虚弱患者的死亡率 (aOR 1.541) 和并发症比老年非虚弱患者更高.
- 非脆弱的老年患者的死亡率 (aOR 2.388) 和并发症高于年轻的非脆弱患者.
- 延迟手术增加了死亡率:非脆弱老年患者>2天,脆弱老年患者>4天.
结论:
- 推迟SBO手术超过2天会增加老年非脆弱患者的死亡率.
- 如果手术延迟超过4天,患有SBO的老年脆弱患者的死亡率会增加.
- 建议包括鼻胃管安置,胃谱挑战,及时的手术干预在2-4天内基于脆弱状态.
更多相关视频
08:17A Mouse Model of Orthopedic Surgery to Study Postoperative Cognitive Dysfunction and Tissue Regeneration
Published on: February 27, 2018
08:26Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
相关概念视频
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
