非心脏手术后慢性病的进展:一个回顾性队列研究
Julian Rössler1, Sascha Ott2, Yufei Li3
1Outcomes Research Consortium, Houston, TX, USA; Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland.
Journal of clinical anesthesia
|January 17, 2025
概括
患有慢性病 (CKD) 的患者在非心脏手术后表现出改善的功能,这与预期相反. 然而,术后急性损伤 (AKI) 在慢性病患者中减少了这些收益,而在其他患者中则恶化了功能.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 外科手术的结果
- 公共卫生 公共卫生
背景情况:
- 慢性病 (CKD) 常见于接受非心脏手术的成年人.
- 手术可能会加剧CKD或导致急性损伤 (AKI).
研究的目的:
- 为了研究非心脏手术患者的长期功能变化,有或没有CKD.
- 为了确定术后AKI对功能轨迹的影响.
主要方法:
- 单中心回顾性队列研究.
- 包括58,175名非心脏手术患者,手术前和后进行肌素测量 (1-2年).
- 主要结局:估计膜过率 (eGFR) 的变化.
主要成果:
- 17%的患者患有手术前的CKD.
- 慢性结核病患者经历了显著的EGFR增加 (45.6至55.6毫升/分钟/1.73米2),而非慢性结核病患者的变化最小 (90.1至92.0毫升/分钟/1.73米2).
- 手术后的AKI否定了CKD患者的eGFR改善,而非CKD患者的eGFR恶化.
结论:
- 手术前的CKD与非心脏手术后的长期eGFR改善有关.
- 手术后的AKI显著影响功能结果,减少CKD患者的益处,并导致其他患者的衰退.
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