膀增大患者的脆弱性:医疗保健利用率和术后结果
Anthony Fadel1, Bridget L Findlay1, Daniel Ubl2
1Department of Urology, Mayo Clinic, Rochester, MN.
Urology
|August 29, 2024
概括
经过膀增大手术的脆弱患者面临着医疗资源利用率和并发症的增加. 术前脆弱性评估对于优化盆腔重建手术的结果至关重要.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 老年人手术是一门老年手术.
- 医疗保健研究成果 研究成果
背景情况:
- 良性骨盆重建手术,特别是膀增大,旨在恢复功能,但可能是资源密集的.
- 患者的脆弱性是影响各种专业外科手术结果的新兴因素.
研究的目的:
- 在接受膀增大手术的患者中,调查脆弱性和医疗资源利用率 (HRU) 之间的关联.
- 为了确定虚弱是否会影响手术后的并发症.
主要方法:
- 美国外科医生学院国家外科质量改进计划 (ACS-NSQIP) 数据库 (2005-2022) 的分析.
- 包括接受膀增大治疗的成年患者.
- 使用五项脆弱指数 (FFI) 评估脆弱性.
- 评估HRU指标,包括长时间停留,再入院,退院继续护理和并发症.
主要成果:
- 较高的脆弱性得分 (FFI ≥2) 与长时间的住院时间 (OR 1.90) 显著相关,继续护理的出院 (OR 2.76) 和整体HRU (OR 2.64).
- 虚弱的患者出现任何并发症 (OR 2.32) 和重大并发症 (Clavien ≥3) (OR 2.56) 的发生率更高.
- 在脆弱性和30天再入院之间没有发现显著的关联.
结论:
- 脆弱性是医疗保健资源利用率增加和膀增大手术患者并发症的独立预测因素.
- 在手术前识别和优化脆弱的患者对于改善良性骨盆重建手术的结果至关重要.
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