急性尾炎的实践模式和临床结果在老年患者中不同
Matteo Maria Cimino1, Alan Biloslavo2, Hayato Kurihara1
1Department of Emergency Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, MI, Italy.
概括
与年轻人相比,患有急性尾炎的老年患者经历了延迟诊断,更多的并发症和更长的住院时间. 需要适应年龄的策略来改善对这个脆弱群体的护理.
科学领域:
- 手术紧急情况的管理.
- 老年医学 老年医学
- 临床结果研究研究的临床结果.
背景情况:
- 尾炎仍然是全球紧急腹部手术的主要原因.
- 人口老龄化在诊断和治疗尾炎方面存在独特的挑战,原因是异常症状和延迟呈现.
研究的目的:
- 为了比较老年患者 (≥65岁) 和年轻成人 (18-64岁) 之间急性尾炎的表现,治疗和结果.
- 确定可能为特定年龄的诊断和治疗方案提供信息的差异.
主要方法:
- 来自ESTES SnapAppy前性观察性队列研究的子组分析.
- 包括15岁及以上的患者,在90天内进行腹腔镜尾切除术.
- 使用适当的测试进行统计比较,显著程度为p < 0.05.
主要成果:
- 老年患者表现出延迟表现 (7.88对3.56天) 和更高的CT扫描利用率 (86.1%对54.0%).
- 复杂性尾炎在老年人中更为频繁 (46.7%对比20.7%),术后并发症的发生率更高 (27.9%对比12.9%) 和住院时间更长 (7.9对比3.6天).
- 老年患者经历了更长的手术时间 (71.1分 vs 60.3分) 和更高的严重并发症发生率 (6.9% vs 2.4%).
结论:
- 在老年人和年轻患者之间,急性尾炎的临床过程和结果存在显著差异.
- 研究结果强调需要适应年龄的诊断途径和治疗策略,以提高老年人群的治疗结果.
- 这项研究突出了一个关键领域,以改善对患有常见手术紧急情况的脆弱人口群体的护理.
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