非恶性食道穿孔的初始管理和结果:全国性住院患者样本分析
Matthew J Ashbrook1, Hailey A Theeuwen1, Vincent Cheng2
1Department of Surgery, University of Southern California, Los Angeles, CA.
Surgery
|July 18, 2024
概括
食道穿孔治疗结果显示,无论干预措施如何,医院内死亡率为11%. 晚年和并发症显著影响食道穿孔管理后的生存率.
科学领域:
- 胃肠病学 胃肠病学
- 外科手术的结果
- 医疗干预 医疗干预
背景情况:
- 食道穿孔管理的选择包括开放式手术,微创手术和内镜支架放置.
- 本研究的重点是分析食道穿孔的初始治疗策略及其短期结果.
研究的目的:
- 为了比较食道穿孔的不同初始治疗的短期结果.
- 确定与住院死亡率和干预后并发症相关的因素.
主要方法:
- 全国住院患者样本 (2015年10月 - 2019年12月) 对于患有食道穿孔的成年患者的回顾性分析.
- 排除食道癌患者;将手术分类为开放式手术,微创手术或内镜支架放置.
- 使用Van Walraven加权的Elixhauser并发症指数和Cox回归来分析住院死亡率和生存率.
主要成果:
- 分析了3345名患者;79%接受了开放式手术,9%进行了微创手术,12%安置了支架.
- 在手术组之间,并发症指数或死亡率没有显著差异,尽管微创手术有更多的胃肠道并发症.
- 总体而言,住院死亡率为11%;年龄较大,并发症指数较高和支架安置与生存率下降有关.
结论:
- 食道穿孔带有11%的住院死亡率和重大并发症,无论最初的干预.
- 增加患者年龄和并发症负担是较差住院生存结果的关键预测因素.
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