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在中年和老年人中进行手术前的消化不良和不良的术后结果
Narmeen Abd El Qadir1, Harrison N Jones2, David A Leiman3
1Department of Otolaryngology- Head & Neck Surgery, Hadassah Medical Center, Jerusalem, Israel.
Journal of clinical anesthesia
|November 29, 2024
概括
手术前的吞障碍 (吞困难) 与手术后更糟糕的结果有关,包括更高的死亡率和并发症. 建议在手术前对食障碍进行查,以改善患者的结果.
科学领域:
- 老年医学 老年医学
- 手术结果研究研究.
- 临床营养学 临床营养学
背景情况:
- 吞失调是一种常见的吞障碍,对健康有重大影响.
- 手术前食障碍对手术患者结局的影响仍未得到充分研究.
- 这项研究探讨了手术前的消化不良和术后的结果之间的关联.
研究的目的:
- 为了调查手术前食障碍对术后结果的影响.
- 为了确定是否有或没有营养不良的消化不良,预测了不良的外科手术结果.
- 为患有吞困难的患者提供术前护理方案的信息.
主要方法:
- 使用国家COVID队列协作 (N3C) 数据库 (2020-2023) 的回顾性观察研究.
- 包括50岁以上接受非吞相关手术的患者.
- 后勤回归分析了手术前消化不良 (±营养不良) 与死亡率,再入院和并发症之间的关联;对于停留时间的负二项回归.
主要成果:
- 分析了380,869名患者 (平均年龄66.0岁);7.9%的人患有手术前的消化不良和/或营养不良.
- 手术前的消化不良 (有或没有营养不良) 与1年死亡率 (OR 1.37) 90天再入院 (OR 1.19) 和医疗/手术并发症 (OR 1.35) 的几率显著增加有关.
- 在对共变量进行调整后,这些关联仍然显著.
结论:
- 手术前的消化不良,有或没有营养不良,是不良术后结果的重要预测因素.
- 这些发现支持将失调查纳入常规手术前评估中.
- 早期识别和干预食障碍可能会减少不良的外科手术结果.
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