在接受紧急腹腔切除术的患者中,虚弱,和身体状况对死亡率的影响
May Myat Thu1, Hwei Jene Ng2, Susan Moug3
1School of Medicine, University of Glasgow, University Place, Glasgow, G12 8QQ, UK.
World journal of emergency surgery : WJES
|April 30, 2025
概括
虚弱和身体状况不佳独立预测紧急腹腔切除术 (EmLap) 后的死亡率. 在这组患者中,肉类症与死亡率没有显著的关联.
科学领域:
- 老年学是一门学科.
- 外科手术的结果
- 临床的脆弱性 临床的脆弱性
背景情况:
- 虚弱和肉是紧急腹腔切除术 (EmLap) 中已知的死亡率预测因素.
- 这些情况可以表明患者的整体身体健康状况.
- 评估这些因素对于理解EmLap结果至关重要.
研究的目的:
- 为了确定EmLap患者的虚弱,肉症和身体状况不佳 (PPS) 的患病率.
- 调查这些因素与短期 (30天,90天) 和长期 (1年) 死亡率之间的关联.
- 探索脆弱性,肉症和PPS对死亡率的综合影响.
主要方法:
- 对紧急拉皮切除术和拉皮镜苏格兰审计 (ELLSA) 数据库 (2017-2019) 的回顾性分析.
- 纳入标准:18岁或以上的患者接受EmLap.
- 使用临床脆弱度量 (CFS) 评估的脆弱性;按总psoas指数 (TPI) 评估的肉;根据美国麻醉学会的身体状况分类 (ASA ≥4) 评估的PPS.
主要成果:
- 在215名EmLap患者中,虚弱 (17.2%), (25.1%) 和PPS (14.4%) 是普遍存在的.
- 虚弱和PPS显著与30天,90天和1年死亡率的增加有关.
- 单独 Sarcopenia 没有显示出与死亡率的显著关联;然而,所有三个因素患者的死亡风险更高.
结论:
- 虚弱和身体状况不佳是紧急腹腔切除术后死亡率的重要独立预测因素.
- 在这种情况下,sarcopenia与死亡率的直接关联需要进一步调查.
- 脆弱性,肉症和PPS之间的相互作用需要进行额外的研究,以改善患者管理.
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