在主要的头癌手术中术后肺炎
Grant Borne1, Mark Knackstedt1,2, Isabella Fabian1
1Department of Otolaryngology-HNS, LSU Health Shreveport, Shreveport, Louisiana, USA.
Head & neck
|April 12, 2025
概括
手术后肺炎 (PPNA) 影响2.8%的头癌患者,增加了住院时间和费用. 贫血和COPD是关键的危险因素,需要有针对性的干预措施来降低PPNA率.
科学领域:
- 在瘤学瘤学.
- 肺部病理学 肺部病理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在接受重大头癌 (HNC) 手术的患者中,术后肺炎 (PPNA) 的发生率和影响尚未得到充分证实.
- 在重大外科手术后,PPNA是一个重大问题,可能会影响患者的治疗结果和医疗保健资源的利用.
研究的目的:
- 为了确定PPNA发生率在接受重大HNC手术的患者中.
- 在这个患者群体中确定与PPNA相关的风险因素.
- 评估PPNA对住院时间和费用的影响.
主要方法:
- 对大型住院患者数据库 (全国住院患者样本,2017-2019年) 的分析,包括超过10,000名接受重大HNC手术的患者.
- 使用ICD-10代码来识别PPNA的病例.
- 采用回归模型来评估伴随性疾病和PPNA之间的关联,以及PPNA对医院结果的影响.
主要成果:
- 在接受重大HNC手术的患者中,PPNA发生在2.8%的患者.
- PPNA与住院时间更长 (中位数为15天而不是6天) 和医院费用更高 (中位数为241,308美元而不是104,697美元) 相关.
- 贫血 (OR: 3.3) 和COPD (OR: 2.0) 被确定为PPNA最强的诱导因素,高血压和痴呆症也显示出显著的关联.
结论:
- 贫血和 COPD 是 HNC 患者中 PPNA 最重要的促成因素.
- 在接受重大HNC手术的患者中,PPNA是增加住院时间和医院费用的强有力的预测因素.
- 手术护理途径应侧重于降低PPNA率,以改善患者的治疗结果和降低医疗保健支出.
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