在非心脏手术后的外科手术中风后与不良结果相关的因素
Jaycee R Farmer1, Jason M Sutherland2, Thalia S Field3
1Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, BC, Canada; Department of Anesthesia, St. Paul's Hospital, Providence Health Care, Vancouver, BC, Canada.
概括
在非心脏外科手术患者的外科中风与高死亡率和不良结果有关. 年龄,BMI和输血等因素会增加风险,但随着时间的推移,结果并没有得到改善.
科学领域:
- 神经外科 神经外科
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 术后中风显著增加非心脏手术患者的死亡率和不良结果.
- 识别相关因素和趋势对于改善患者护理至关重要.
- 这项研究调查了30天死亡率,不良出院和住院时间的预测因素.
研究的目的:
- 确定与非心脏手术患者的30天死亡率,不良出院和术后中风后住院时间长度相关的因素.
- 分析2005年至2020年期间这些结果的趋势.
- 为了告知潜在的干预措施,以改善这一高风险人群的结果.
主要方法:
- 使用美国外科医生学院国家外科质量改进计划 (ACS-NSQIP) 数据库 (2005-2020) 的回顾性队列研究.
- 包括14,386名经历手术前中风的非心脏手术患者.
- 弹性净惩罚确定了与30天死亡率,不良出院和住院时间长度相关的变量.
主要成果:
- 术后中风发生在手术后5天的中位数.
- 24.6%的患者在30天内死亡,39.8%的患者被送往非家庭设施.
- 与30天死亡率相关的因素包括年龄,BMI,术后并发症,中风时间和术后输血. 在研究期间,没有观察到死亡率或不良出院的显著变化.
结论:
- 年龄,BMI,术后并发症,中风时间和术后输血是术后中风不良结果的重要风险因素.
- 潜在的可改变因素,如外科手术期间的贫血和输血,需要进一步调查.
- 需要进行额外的研究来开发有效的干预措施,以改善经历外科手术期间中风的患者的治疗结果.
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