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根据脏疾病严重程度的术后处置的差异:基于人口的队列研究
Tyrone G Harrison1, Tayler D Scory2, Brenda R Hemmelgarn3
1Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary; O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary; Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary.
概括
患有晚期病的患者经历了更长的住院时间和更频繁的出院,在进行重大非心脏手术后更频繁地出院到护理设施. 功能障碍的严重程度与恢复时间的增加和出院后独立性的减少有关.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 外科手术的结果
- 公共卫生 公共卫生
背景情况:
- 晚期病患者在非心脏手术期间面临更高的风险.
- 术前功能障碍对术后结果的影响,如住院时间和出院处置,尚不清楚.
研究的目的:
- 调查术前功能障碍严重程度与术后住院时间和出院时间之间的关联.
- 根据功能,分析接受重大非心脏手术的患者的结果.
主要方法:
- 基于人口的回顾性队列研究,使用加拿大阿尔伯塔省的数据 (2005年4月至2019年2月).
- 包括接受住院重大非心脏手术的成年人.
- 暴露被按手术前估计的球过率 (eGFR) 或功能衰竭状态分类.
主要成果:
- 分析了近100万次手术. 透析患者的停留时间最长 (LOS),超过正常功能患者的两倍.
- 透析患者在手术后的30天内在家活着的日子显著减少,并且被送往24小时护理机构的可能性几乎是4倍.
- 随着功能水平的下降,观察到不良结果的逐渐增加.
结论:
- 患有脏疾病的患者,特别是严重阶段的患者,经历了长时间的医院康复,并在重大手术后需要更多的退院后护理支持.
- 这些发现突出了与正常功能患者相比,患有脏疾病的患者在手术恢复中的显著差异.
- 需要进一步的研究,以确定长时间住院的预测因素,并制定干预措施,以便在这个人群中更早出院.
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