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老年人急性四肢缺血:确定死亡率因素
Kivanc Kacar1, Tugra Gencpinar1, Kivanc Metin1
1Department of Cardiovascular Surgery, Dokuz Eylül University Faculty of Medicine, İzmir, Türkiye.
预测患有急性四肢缺血的老年患者的死亡率至关重要. 功能依赖,缺少心房动和高中性粒细胞与淋巴细胞的比率是增加死亡风险的关键指标.
科学领域:
- 血管外科 血管外科
- 老年医学 老年医学
- 关键护理医学 关键护理医学
背景情况:
- 急性四肢缺血症 (ALI) 在老年手术患者中存在显著的死亡风险.
- 确定死亡率的预测因素对于改善患者的治疗结果至关重要.
研究的目的:
- 为了确定与ALI手术的老年患者的术后和一年死亡率相关的因素.
- 评估中性粒细胞与淋巴细胞比率 (NLR),功能依赖性和心房的预测值.
主要方法:
- 对205名患者 (平均年龄为77.7岁) 的回顾性分析,这些患者因ALI接受了栓塞切除术.
- 用多变量回归和卡普兰-梅尔生存分析来评估死亡率预测因素.
- 确定了数值变量的切断值.
主要成果:
- 手术后和一年死亡率分别为35.1%和56.6%.
- 功能依赖 (OR 7.3),缺失心房动 (OR 3.3) 和NLR>5.91 (OR 9.1) 是术后死亡率的重要预测因素.
- 功能依赖,缺少心房动,NLR>5.85对一年生存率产生了负面影响.
结论:
- 缺少心房动,功能依赖和高的NLR是老年ALI患者死亡率的显著预测因素.
- 这些因素可以有助于风险分层和临床决策,用于ALI管理.
- 进一步的研究可能会根据这些已识别的风险因素探索针对性的干预措施.
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