部骨折手术治疗的时间 部骨折护理
Haoyan Zhong1, Jashvant Poeran1,2, Alex Illescas1
1Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, New York, USA.
Journal of the American Geriatrics Society
|July 4, 2024
概括
延迟关节骨折手术增加了并发症的风险. 与同一天手术相比,在第二或第三天接受手术的患者出现较高的重大并发症,死亡率和重症监护室 (ICU) 住院率.
科学领域:
- 整形外科手术 整形外科手术
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 对关节骨折的及时手术干预与更好的患者结果有关.
- 目前的实践指南建议在入院后24-48小时内进行手术.
- 最近关于关节骨折手术时间对结果的影响的数据有限.
研究的目的:
- 评估关节骨折手术的时间和患者的结果之间的关联.
- 为了确定延迟手术超过24小时是否会影响重大并发症,死亡率或ICU入院.
主要方法:
- 使用Premier Healthcare索赔数据 (2006-2021) 的回顾性队列研究.
- 包括患有关节骨折的患者,在入院后3天内进行手术修复.
- 根据手术时间 (0-1天,2天,3天) 分析了包括重大并发症,死亡率和ICU入院在内的结果.
主要成果:
- 分析了超过50万名关节骨折患者;只有26%的患者在0-1日接受了手术.
- 在第二天或第三天进行手术与严重并发症,死亡率和ICU入院的几率显著增加有关.
- 这些关联在调整为主要并发症 (p < 0.001) 后仍然存在 (p < 0.001).
结论:
- 尽管有指导方针,但大多数关节骨折患者在第二或第三天接受手术,导致结果更差.
- 及时的手术干预对于改善关节骨折患者的治疗结果至关重要.
- 需要进一步的研究来平衡临床因素并优化手术时间.
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