评估八十多岁的死亡预测因子 接受紧急或紧急创伤腹腔切除术的八十多岁人群
Jordan G Shin1, Jeffry Nahmias1, Elliot Silver1
1Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, University of California, Irvine, Orange, CA, USA.
概括
肝硬化和并发胸切除术显著增加了老年创伤患者接受紧急或紧急腹腔切除术的死亡风险. 创伤前的功能状态本身不应该决定治疗的徒劳性.
科学领域:
- 创伤外科 手术 创伤外科
- 老年医学 老年医学
- 手术结果研究研究.
背景情况:
- 八代创伤患者代表着一个具有高死亡率的脆弱人群.
- 在这个人口群体中,紧急或突发性腹腔切除术 (UEL) 存在重大风险.
- 识别特定的风险因素对于改善患者的治疗结果至关重要.
研究的目的:
- 为了确定八十岁创伤患者接受UEL的死亡相关风险因素.
- 分析影响生存的患者特异性和程序相关因素.
- 为这个患者群体提供临床决策和资源分配的信息.
主要方法:
- 80-89岁的创伤患者在抵达后6小时内接受UEL的回顾性国家分析.
- 多变量后勤回归分析以确定死亡率的独立风险因素.
- 在幸存者和非幸存者之间比较人口,临床和受伤相关的变量.
主要成果:
- 在接受UEL的八十岁创伤患者中,死亡率为46.2% (324/701).
- 在未幸存者中观察到更高的肝硬化,大脑,心脏和肺部损伤率.
- 肝硬化是最强的独立患者相关风险因素 (OR 8.28).
- 同时进行胸切除术显著增加了死亡风险 (OR 16.59).
结论:
- 预先存在的疾病,如肝硬化,需要在八十多岁的创伤患者中进行谨慎的管理.
- 护理的徒劳性不应该仅仅基于创伤前的功能状态.
- 除了腹腔切除外,同时进行胸腔切除实质上增加了死亡风险,需要谨慎考虑.
相关概念视频
01:22Aneurysm IV: Nursing Management
3
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
3
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
3
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
3
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
53
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
53