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在接受非选择性腹部手术的透析患者中出现重大外科期间出血

Joy Zhou Done¹, Claire A Ostertag-Hill², Olivia Ziegler¹

¹The Warren Alpert Medical School of Brown University, Providence, Rhode Island.

The Journal of surgical research

|December 29, 2024

概括

经过非选择性腹部手术的末期病 (ESRD) 患者面临高出血风险. 术前实验室值和患者特征有助于评估出血风险,这与死亡率增加有关.

科学领域:

腎臟病學 (nephrology) 是一種醫學專業.
外科手术的结果
患者安全患者安全

背景情况:

末期病患者 (ESRD) 患有外科手术出血并发症的风险较高.
对接受非选择性腹部手术的ESRD患者进行术前风险评估和降低策略尚未明确.
这项研究调查了在接受腹部新生手术的透析患者的出血风险因素.

研究的目的:

为了确定在接受非选择性腹部手术的透析患者中出现重大外科期间出血的患病率.
为了确定与此种人群中重大外科手术前出血相关的危险因素.
为了比较患有和没有重大术后出血的患者之间的30天死亡率.

主要方法:

利用美国外科医生学院国家外科质量改进计划数据库 (2005-2017).
在透析中接受非选择性腹部手术的确定的患者使用当前程序术语代码.
计算出出血率并使用多变量逻辑回归来确定风险因素和相关死亡率.

主要成果:

在9102名透析患者中,超过30%的患者经历了严重的术后出血;22%的患者在30天内死亡.
风险因素包括女性性别,功能依赖,呼吸机使用,扩散癌症,类固醇使用,PTT,BUN升高,贫血和低albuminemia.
与流相比,肝脏,脏和胰腺手术携带的出血风险最高.

结论:

末期脏病患者接受突发腹部手术的大量出血率需要输血.
术前实验室异常和患者特征对于评估术后出血风险是有价值的.

关键词:

流血出血流血出血透析是通过透析进行的.欧洲发展与发展委员会 (ESRD)非选择性手术是没有选择性的手术.输血输血输血输血

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