转变的潮流:不断变化的并发症概况,人口结构的转变,以及主要的下肢截肢意外增加
Panos Kougias1,2, Sherene E Sharath1,2,3, Claire Ferguson1
1Department of Surgery, State University of New York Downstate Health Sciences University, Brooklyn, NY.
Annals of surgery
|June 23, 2025
概括
自2010年以来,膝盖以上 (AKA) 和膝盖以下 (BKA) 的下肢截肢事件增加了. 风险因素已经转移,年轻,白人,肥胖和高血压患者现在更常见,特别是那些接受BKA的患者.
科学领域:
- 血管外科 血管外科
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 主要的下肢截肢发生率数据需要更新.
- 截肢预防计划和重血管化技术可能会减少发生率.
- 截肢率的最近趋势没有得到充分的记录.
研究的目的:
- 确定膝盖以上截肢 (AKA) 和膝下截肢 (BKA) 发生率的预测因素和趋势.
- 分析经历重大截肢的患者的人口统计和并发症变化.
- 评估风险因素对截肢发生率随时间推移的影响.
主要方法:
- 利用国家住院患者样本来确定动脉样硬化和截肢的入院情况.
- 从1993年到2021年分析了BKA和AKA发病率的趋势.
- 采用多层逻辑回归和人口归因分数来确定预测因素和风险因素贡献.
主要成果:
- 2010年以后,BKA发病率的下降反转了 (每年增长9%),而AKA发病率在2012年以后反转了 (每年增长4%).
- 无论是BKA还是AKA的平均年龄都显著下降.
- 2010年后,BKA患者更有可能是年轻的,白人,肥胖和高血压患者; AKA患者也显示出人口结构的变化.
结论:
- 自2010年以来,主要截肢发生率有所上升,患者人口统计和并发症的显著转变.
- 代谢综合征越来越多地与主要的下肢截肢有关.
- 治疗策略需要重新评估,以应对不断变化的风险因素概况.
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