使用修改过的虚弱指数作为成年人经过跨面体间腰部融合的并发症的预测指标
Momin M Mohis1,2, Simon G Ammanuel3, Cuong P Luu2
1Department of Neurological Surgery, University of Chicago, Chicago, IL, USA.
World neurosurgery: X
|October 15, 2024
概括
患者的脆弱性显著影响了跨腰腰体融合 (TLIF) 的结果. 高脆弱性预测了TLIF手术后的意外再入院,重大并发症和机构出院.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 患者的治疗结果.
- 脆弱性评估 脆弱性评估
背景情况:
- 跨腰椎体间融合 (TLIF) 是一种常见的脊柱手术.
- 越来越多地认识到患者的脆弱性是影响外科手术结果的因素.
- 有限的数据存在,将脆弱性与多中心环境中的TLIF结果相关联.
研究的目的:
- 评估患者脆弱性和手术特征以及TLIF后的并发症之间的关系.
- 确定脆弱性作为TLIF患者不良结果的预测因素.
- 分析多中心数据以进行可靠的相关性分析.
主要方法:
- 利用美国外科医生学院国家外科质量改善 (ACS-NSQIP) 数据库 (2015-2020).
- 将患者分层分为低脆弱性和高脆弱性队列,使用修改后的脆弱性指数5 (mFI-5) 评分.
- 进行单变量和多变量分析,以确定脆弱性对结果的影响.
主要成果:
- 高脆弱性队列的无计划再入院率 (6.6%与4.3%) 和整体并发症率 (13.8%与9.8%) 显著上升.
- 高脆弱性患者住院时间较长 (3.69 vs 3.27天),更有可能出院 (77.9% vs 89.6%).
- 传染性并发症的发生率在很大程度上是相似的,而非传染性结果在脆弱群体之间有显著差异.
结论:
- 修改后的脆弱指数5 (mFI-5) 有效地预测了TLIF的外科手术结果.
- 高脆弱性状态是TLIF后计划外再接收,重大并发症和出院目的地的独立预测因素.
- 脆弱性评估应纳入TLIF患者的手术前规划,以优化结果.
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