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在脆弱性关节骨折患者手术后尿的危险因素:一项前性研究

Direk Tantigate¹, Nathanan Jansatjawan¹, Nath Adulkasem¹

¹Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.

|June 3, 2024

概括

在老年关节骨折患者中,术后尿 (POUR) 与抗胆固醇药物,高IPSS得分和有限的运动能力有关. 一个新的查工具在识别有风险的个体方面表现出色.

科学领域:

老年医学老年医学
整形外科手术整形外科手术
泌尿器科泌尿器科泌尿器科泌尿器科

背景情况:

手术后的尿 (POUR) 是患有部骨折的老年人常见的并发症,可能导致延迟行走和感染等不良结果.
虽然导管管理可以预防一些病例,但在导管切除后仍可能出现POUR,需要进一步干预.
识别风险因素和开发预测工具对于管理这种脆弱人群中的POUR至关重要.

研究的目的:

为了确定手术后尿留 (POUR) 的重大风险因素,在老年患者接受骨折骨折手术.
开发和验证一种查工具,用于预测尿导管切除后患者的POUR.

主要方法:

一项前性队列研究,涉及145名年长的患有脆弱性关节骨折的老年患者,在2020年9月至2022年5月期间接受手术治疗.
患者被评估尿液保留使用膀扫描后导管去除的膀扫描.
收集了有关潜在风险因素的数据,以开发一个查工具.

主要成果:

在15.2%的患者中 (22在145人中) 诊断出POUR.
通过多变量逻辑回归确定的显著风险因素包括抗胆固醇药物使用 (OR=11.9),国际前列腺症状评分 (IPSS) ≥8 (OR=9.3),以及在术后24小时内无法独立动员 (OR=6.5).
开发的选工具表现出卓越的性能,接收器操作特征曲线 (AuROC) 下的面积为0.85.

结论:

抗胆固醇药物使用,高IPSS得分 (≥8) 和术后运动能力受损是该患者群中POUR的关键预测因素.
为POUR选开发了一种经过验证的评分系统,需要进一步的外部验证.

关键词:

部骨折部骨折部骨折年龄较大的老人在Pour Pour的时候.选工具是一个选工具.保持尿液的时间

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