虚弱和身体构成预测紧急整体外科住院后的不良结果:一个多中心观察队列研究
P May-Miller1, Map Ligthart2,3, A R Darbyshire4
1Salisbury NHS Foundation Trust, UK.
Annals of the Royal College of Surgeons of England
|November 21, 2024
概括
脆弱性和身体组成分析 (BCA) 显著预测紧急手术患者的不良结果. 将这些措施结合起来,可以更好地预测死亡率和出院目的地的风险.
科学领域:
- 老年学是一门学科.
- 手术科学 手术科学
- 放射学 放射学是一门学科.
背景情况:
- 紧急手术入院涉及重病患者.
- 脆弱和身体成分是已知的不良结果的风险因素.
- 这些因素在紧急手术环境中很少一起分析.
研究的目的:
- 调查脆弱性和身体成分对紧急普通手术患者死亡率的综合影响.
- 为了确定脆弱性和身体组成分析 (BCA) 对不良结果的预测值.
主要方法:
- 一个前性的多中心观察队列研究.
- 使用L3脊椎的CT扫描来分析身体组成,以评估缩症和骨髓变.
- 使用报告的埃德蒙顿脆弱度量表 (REFS) 来评估脆弱性.
- 使用后勤回归模型分析死亡率和出院结果.
主要成果:
- 24%的患者是虚弱的,25%是肉骨的,23%是肌骨的.
- 虚弱的患者患上了较高的肉类和骨髓变症.
- 虚弱患者 (31.9%) 和患有肉病 (2.88 OR) 或虚弱 (4.13 OR) 的患者的一年死亡率显著更高.
- 在脆弱患者中,独立排泄较少 (55.3%与88.4%相比).
结论:
- 虚弱,肉类和骨髓病是紧急手术患者不良结果的重要因素.
- 对脆弱性和身体成分的综合评估提高了风险分层.
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