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在重大下肢截肢之后,老年人的伤口愈合
Maja Wichhart Donzo1, Nathaniel Forrester1, Chengcheng Hu2
1Emory University School of Medicine, Atlanta, GA.
经过下肢截肢 (LEA) 的老年人 (80岁以上) 比年轻患者愈合得更快. 高龄并不影响假肢安装率,这表明年龄本身不应该限制LEA资格.
科学领域:
- 老年医学 老年医学
- 血管外科 血管外科
- 伤口治愈研究研究 伤口治愈研究
背景情况:
- 老年人往往有多种慢性疾病,增加了对下肢截肢 (LEA) 后伤口愈合的生理需求.
- 膝下截肢 (BKA) 通常比膝上截肢 (AKA) 提供更好的结果,但必须考虑伤口并发症.
研究的目的:
- 对接受LEA.患者的晚年 (80岁以上) 和伤口愈合结果之间的关联进行调查.
- 为了比较老年和年轻的LEA患者之间的假肢安装率和伤口愈合时间.
主要方法:
- 在两个学术医疗保健系统中对LEA患者 (2015-2022) 的回顾性审查.
- 排除患有先前ipsilateral LEA的患者.
- 分析使用Cox比例危险模型的高级年龄 (>80) 作为暴露和伤口愈合时间作为主要结果.
主要成果:
- 在597名LEA患者中,8.9%的患者年龄超过80岁.
- 高龄和年轻人之间的假肢安装率没有显著差异 (47.1%与58.5%,P=0.11).
- 晚年与较快的伤口愈合有关 (HR 1.42;95% CI,1.06-1.87),即使被截肢水平分层.
结论:
- 80岁以上的患者在LEA后的伤口愈合速度较快,与年轻的同行相比.
- 高龄不应该是LEA资格或假肢候选人的唯一决定因素.
- 需要进一步的研究来确定其他影响老年人伤口愈合的临床因素.
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