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揭穿"肥胖悖论":肥胖与紧急整体外科手术的不良结果有关

Emanuele Lagazzi¹, Ikemsinachi C Nzenwa¹, Wardah Rafaqat¹

¹Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, Massachusetts.

The Journal of surgical research

|June 25, 2024

概括

较高的肥胖类与紧急整体外科手术的风险增加相关,包括更长的手术时间和更长的住院时间. 这凸显了对BMI进行进一步研究的需要.

科学领域:

外科手术的结果
肥胖问题研究研究
紧急情况一般外科手术

背景情况:

在一般人群和紧急整体外科 (EGS) 患者中,肥胖的患病率正在上升.
之前的研究表明,肥胖可能会保护EGS的死亡率.
身体质量指数 (BMI) 对EGS手术后结果和手术内决策的影响还未得到充分研究.

研究的目的:

研究身体质量指数 (BMI) 与EGS手术后结果之间的关联.
探索BMI与EGS中手术内决策之间的关系.
分析BMI对EGS并发症和资源利用的影响.

主要方法:

使用了国家外科质量改进计划 (NSQIP) 数据库 (2015-2019).
包括因EGS疾病而接受开放腹部或腹壁手术的成年患者.
采用多变量逻辑回归来分析结果 (30天死亡率,发病率,延迟关闭,重新手术,手术时间,LOS),调整为患者和程序变量.

主要成果:

在各种BMI类别中确定了78,578名患者.
第三类肥胖是30天术后发病率的风险因素 (aOR 1.14,P < 0.01).
增加的肥胖类与较高的关闭延迟率,较长的手术时间和延长的住院时间 (LOS) 相相关.

结论:

肥胖类与EGS中延迟关闭的增加,更长的手术时间,更高的重新手术率和延长的医院LOS有关.
需要进一步的研究来了解BMI对手术内因素和手术决策的影响.
研究BMI对医院费用的贡献也是有必要的.

关键词:

这就是为什么BMI是BMI.紧急外科手术紧急外科手术拉皮切除术 (Laparotomy) 是一个切除术.肥胖问题肥胖问题肥胖悖论肥胖悖论结果的结果.

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