肝硬化严重程度与关节骨折修复后的结果的关联:使用大型住院患者数据库进行倾向-得分匹配分析
Osamu Hamada1, Takahiko Tsutsumi1, Ayako Tsunemitsu1
1Department of General Internal Medicine, Takatsuki General Hospital, Osaka, Japan; Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
概括
部骨折手术的结果随着肝硬化的严重程度而恶化. 与B类相比,患有Child-PughC类肝硬化症的患者在医院内死亡率明显高,需要仔细评估风险.
科学领域:
- 整形外科手术 整形外科手术
- 肝病学 肝病学是一种肝病学.
- 公共卫生 公共卫生
背景情况:
- 晚期肝硬化增加了外科手术死亡风险,但其对关节骨折患者的影响尚不清楚.
- 关节骨折在老年人群中很常见,通常与肝硬化等并发症有关.
研究的目的:
- 为了研究肝硬化严重程度 (Child-Pugh类A,B,C) 与关节骨折患者的术后结果之间的关联.
- 为了比较不同肝硬化严重程度组的住院死亡率,住院时间,住院费用,再入院和并发症率.
主要方法:
- 从2010年7月到2021年3月,对一个大型的日本全国性行政数据库 (诊断程序组合数据库) 的分析.
- 包括833648名接受手术的关节骨折患者.
- 1:1倾向性得分匹配比较非肝硬化,儿童皮格A,B和C组.
主要成果:
- 在非肝硬化和Child-Pugh A组之间,住院死亡率相似.
- 死亡率从Child-Pugh A到B (5.9%对1.5%) 显著增加,并进一步从B到C (28.4%对6.3%).
- 更高的Child-Pugh课程与更长的住院时间,更高的费用和更多的并发症相关.
结论:
- 肝硬化严重程度是影响部骨折手术结果的关键因素.
- 儿童-普格C级与部骨折手术后医院死亡率大幅增加有关.
- 风险与益处的讨论必须纳入肝硬化严重程度,以获得最佳的患者护理决策.
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