什么时候老不是黄金? 确定全球年龄风险外科手术门以改善结果
Komal Abdul Rahim1, Kinzah Razzak Ghazi2, Kantesh Kumar3
1Centre of Excellence for Trauma and Emergencies & Dean's Office, Aga Khan University, Karachi, Pakistan.
The Journal of surgical research
|June 29, 2025
概括
确定手术风险分层的最佳年龄门至关重要. 巴基斯坦52.595岁及以上的患者面临术后死亡率和并发症的增加,需要针对性干预.
科学领域:
- 手术成果研究的研究结果.
- 老年人手术是一项老年人手术.
- 医疗服务研究 医疗服务研究
背景情况:
- 患者年龄显著影响医疗保健结果,但最佳风险值仍然不清楚.
- 有限证据表明,特定的年龄限制增加了不良外科手术结果,特别是在低收入和中等收入国家.
- 术前风险分层对于优化手术结果和指导临床决策至关重要.
研究的目的:
- 确定在巴基斯坦将手术患者归类为高风险的最佳年龄门.
- 为了利用修改后的脆弱指数进行手术前风险分层.
- 为了告知临床决策和改善外科手术的结果.
主要方法:
- 美国外科医生学院分析国家外科质量改进计划数据 (2019-2022年).
- 使用修改的脆弱指数 (得分≥2) 识别高风险患者.
- 应用接收机-运营商曲线 (ROC) 分析来确定最佳年龄值和危险比率的Cox比例回归.
主要成果:
- 总共有10,060名患者被分析,确定高风险的最佳年龄值为52.595岁 (AUC 0.72).
- 年龄在52.595岁及以上的患者的术后死亡率是术后死亡率的两倍 (2.95%与1.11%),并发症率更高 (27.01%与19.28%).
- 病情急性和术后心脏并发症是这两组风险人群死亡率的重要预测因素.
结论:
- 年龄是与手术患者中不良结果相关的重要因素.
- 确定高风险手术患者的年龄门对于在低收入和中等收入国家实施有针对性的干预措施至关重要.
- 这项研究为风险分层提供了关键的年龄切断,以改善巴基斯坦的外科护理.
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