在患有病理性骨骨折的患者中,延迟手术时间与术后并发症的增加有关吗?
Emma Smolev1,2, Richard M Marchese3, Varun Sriram4
1Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA. Emma.Smolev@stonybrookmedicine.edu.
概括
病理性骨骨折的延迟手术没有增加30天后的并发症. 然而,与非病理性骨折不同,它与更长的住院和非家庭出院有关.
科学领域:
- 整形外科手术 整形外科手术
- 创伤外科 手术 创伤外科
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在骨科创伤中推迟手术与增加的发病率,死亡率,住院和成本有关.
- 对于非病理性骨骨折,治疗后≥3天的延迟与更高的并发症风险有关.
- 延迟手术对病理性腰骨骨折的影响在很大程度上仍未得到研究.
研究的目的:
- 为了识别与病理骨骨折的延迟手术相关的风险因素.
- 调查患者的特征,并发症和与手术延迟相关的术后并发症.
- 为了确定延迟手术是否会影响病理骨骨折的结果.
主要方法:
- 使用美国外科医生学院国家外科质量改善计划 (ACS NSQIP) 数据库 (2015-2021) 的回顾性队列研究.
- 包括接受手术治疗病理性腰骨骨折的患者.
- 术后延迟术定义为从入院到手术≥2天;分析了30天的术后并发症.
主要成果:
- 在248名患者中,有39.9%的患者经历了手术延迟 (≥2天).
- 与延迟相关的因素包括ASA分类≥3,依赖功能状态和充血性心力衰竭.
- 独立地,推迟手术预测了非家庭出院 (OR: 2.93) 和延长住院时间 (OR: 2.00).
结论:
- 病理性骨骨折的延迟手术 (≥2天) 独立地与非家庭出院和延长的术后停留有关.
- 与非病理性骨折不同的是,病理性骨骨折的延迟手术与增加的30天并发症没有独立联系.
- 研究结果表明,虽然延迟影响排放和停留时间,但它们不会显著增加这些特定骨折的短期并发症.
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