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萨尔科佩尼亚是患有炎症性肠病的老年人中术后并发症的危险因素
Ria Minawala1, Michelle Kim1, Olivia Delau2
1Department of Medicine, NYU School of Medicine, New York, NY, USA.
通过骨肌肉指数 (SMI) 测量的萨科佩尼亚,增加了老年炎症性肠病 (IBD) 的术后并发症风险. 术前SMI评估可以帮助这些接受肠切除的患者的风险分层.
科学领域:
- 老年医学 老年医学
- 胃肠病学 胃肠病学
- 外科手术的结果
背景情况:
- 萨科佩尼亚与老年人手术结果不佳有关.
- 它对患有炎症性肠病 (IBD) 的老年人的影响仍未得到充分研究.
- 在IBD患者中现有的肉类症评估缺乏标准化,产生不一致的结果.
研究的目的:
- 为了调查萨尔科佩尼亚和老年人 (≥60岁) 经过肠切除的IBD的30天术后结果之间的关联.
- 为了比较骨肌肉指数 (SMI) 和总Psoas指数 (TPI) 对不良结果的预测性表现.
- 为了确定这一群体中不良术后结果的危险因素.
主要方法:
- 对120名60岁以上IBD患者进行了肠切除的回顾性研究 (2012-2022年).
- 骨肌肉指数 (SMI) 和总Psoas指数 (TPI) 由手术前CT扫描测量.
- 多变量后勤回归用于评估风险因素和结果 (死亡率,并发症).
主要成果:
- 40%的患者经历了30天的不良术后结果 (例如感染,再入院,AKI).
- 与TPI (AUC 0.58) 相比,SMI在不良事件 (P=.02) 中表现出更好的预测性表现 (AUC 0.66).
- 增加SMI与不良结果风险降低有关 (adjOR 0.88),而之前的手术和败血症增加了风险.
结论:
- 通过SMI评估的 Sarcopenia 是老年IBD患者术后并发症增加的重要预测因素.
- 术前SMI测量对于接受肠切除的老年IBD患者的风险分层是有价值的.
- SMI可以帮助优化手术规划和患者管理.
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