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Rebecca Empey¹, Hyunkyu Ko¹, Ram Nirula²

¹Surgery, University of Utah Health, Salt Lake City, Utah, USA.

Trauma surgery & acute care open

|January 22, 2025

概括

常规的术后第一天 (POD1) 实验室用于紧急整形外科 (EGS) 患者通常是不必要的. 识别程序持续时间和血液损失等预测因素可以帮助安全地省略实验室,减少过度测试.

科学领域:

紧急的一般外科手术.
术后护理术后护理
实验室测试实验室测试实验室测试

背景情况:

晨间术后实验室对于紧急普通手术 (EGS) 患者来说很常见.
研究表明,常规的术后第一天 (POD1) 实验室可能过度,不需要其他外科领域的干预.

研究的目的:

确定对EGS患者POD1实验室的必要性的预测因素.
确定与实验室干预可能性相关的因素.

主要方法:

从2022-2023年对502名非危急病患者的回顾性评估.
使用多变量逻辑回归和LASSO回归分析.
确定了异常结果和干预可能性的预测因素.

主要成果:

手术持续时间,发烧,粘结溶解,手术前低血压,老年,心力衰竭,失血,慢性病和抗凝血预测异常实验室 (AUC=0.785).
手术持续时间,年龄较大,估计血液损失较高 (EBL),抗凝血和粘结溶解预测干预 (AUC=0.704).
程序>400分 (84.3%) 和EBL>200mL (75.5%) 增加了需要干预的异常实验室的机会.

结论:

在非危急病的EGS患者中,POD1实验室很少需要干预,并且经常可以省略.
考虑实验室进行更长的手术,更高的EBL,老年患者,使用抗凝剂或粘附后溶解.

关键词:

诊断检查,常规检查,常规检查紧急医疗服务紧急医疗服务整体外科的一般手术.

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