90岁或以上患者的紧急腹部手术的预测因素:一项回顾性研究
Atsushi Horiuchi1, Shun Akehi1, Yuta Fujiwara1
1Department of General Surgery, Ehime Prefectural Niihama Hospital, Japan.
Surgery open science
|August 2, 2024
概括
90岁或以上的患者的紧急腹部手术具有可预测的风险. 这项研究确定了影响并发症和死亡率的关键因素,有助于患者和家庭咨询.
科学领域:
- 老年人手术是一门老年人手术.
- 手术结果研究研究.
- 紧急医疗 紧急医疗
背景情况:
- 越来越多的老年患者 (≥90岁) 接受手术.
- 在这个人口群体中专注于紧急腹部手术.
- 需要了解影响非老年人手术患者结果的因素.
研究的目的:
- 确定影响90岁及以上,接受紧急腹部手术的患者在医院内发病率和死亡率的因素.
- 为了评估POSSUM和P-POSSUM评分系统的预测准确度.
- 为明智决策和患者咨询提供数据.
主要方法:
- 对于46例紧急腹部手术的回顾性分析,这些手术发生在≥90岁的患者身上 (2011-2022年).
- 对影响发病率和死亡率的因素进行统计分析.
- 用POSSUM预测的死亡率和P-POSSUM预测的死亡率来计算生理和手术严重性得分.
主要成果:
- 高并发症率 (65.2%) 和住院死亡率 (10.8%).
- 影响发病率的因素:ASA得分,手术时间,血液损失,手术严重程度得分. 多变量:男性性别,手术严重程度得分,住院时间.
- 影响死亡率的因素:ECOG表现状态,生理学得分. 多变量:生理学得分.
- 在POSSUM和P-POSSUM中,预测准确度中等 (AUC分别为0.796和0.805).
结论:
- 在非老年人紧急腹部手术的风险分层是可能的.
- 生理学得分是住院死亡率的重要预测指标.
- 数据可以支持关于手术风险和结果的患者和家庭讨论.
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