消化管切除术后何时需要进入重症监护室?
Erin Sahm1, Olatoye Olutola2, Ashar Ata3
1Albany Medical College, Albany, New York.
The Journal of surgical research
|May 29, 2024
概括
消化管切除术后的关键并发症通常发生晚期,在初始重症监护室 (ICU) 住院后. 优化ICU时间可以改善对食道切除术患者的患者护理和资源使用.
科学领域:
- 手术瘤学手术瘤学
- 关键护理医学 关键护理医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- oesophagectomies 携带高发病率,需要在重症监护室 (ICU) 入院进行术后监测.
- 在最初的ICU停留后,危急并发症可能会出现,这表明当前的监测时间可能不足于最佳.
- 鉴定食道切除术后并发症的关键时期对于优化患者护理至关重要.
研究的目的:
- 为了确定食道切除术后关键并发症的时间.
- 确定与这些并发症相关的风险因素.
- 为最佳的术后监测策略提供信息.
主要方法:
- 分析国家安全和质量改善计划数据库 (2016-2021年).
- 包括接受食道切除术的患者.
- 多变量回归以确定关键并发症的风险因素,定义为需要接受ICU治疗的事件 (例如,呼吸衰竭,败血性休克).
主要成果:
- 总共有6813名患者被纳入.
- 21.59%的患者在手术后30天内出现严重并发症.
- 一半的关键并发症发生在术后第5天,其中85.05%发生在第2天之后.
- 风险因素包括年龄超过60岁,并发症和开放性手术;恶性瘤是保护性的.
结论:
- 关键并发症经常发生在手术后的直接后期.
- 接受微侵袭性食道切除术的低风险患者可以在重症监护室外安全监测.
- 调整ICU监测时间可以提高患者护理和资源配置.
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