由于下肢创伤而进行重血管化后,与医院截肢相关的因素
Vy Thuy Ho1, Shernaz Sophia Dossabhoy2, Lakshika Tennakoon3
1Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Vascular
|July 8, 2025
概括
下肢创伤重血管化的截肢率为10.2%. 诸如形伤害,尾动脉损伤和骨折等因素增加了截肢风险,强调了及时分类来挽救肢体.
科学领域:
- 创伤外科 手术 创伤外科
- 血管外科 血管外科
- 整形外科手术 整形外科手术
背景情况:
- 同时的血管损伤增加了下肢创伤中截肢的风险.
- 再血管化后截肢的危险因素不太清楚,特别是在缺乏专门的血管创伤专业知识的中心.
- 有效的分类和转移协议对于高风险血管创伤病例的最佳结果至关重要.
研究的目的:
- 为了确定与隔离下肢创伤的动脉再血管化后的医院截肢相关的因素.
- 为管理高风险血管创伤患者提供指导.
- 通过更好的患者分类来提高肢体救援率.
主要方法:
- 使用美国外科医生学院创伤质量改善计划 (ACS TQIP) 数据库 (2017-2021).
- 分析了因孤立的下肢创伤而接受动脉再血管化的成年患者的数据.
- 执行单变量和多变量逻辑回归以确定截肢预测因子.
主要成果:
- 在5669名重新血管化的患者中,有10.2%的患者进行了截肢.
- 高龄和有外围动脉疾病史与更高的截肢率有关.
- 形伤害机制,形动脉损伤和同时发生的骨损伤独立预测截肢.
结论:
- 在隔离的下肢创伤中,整体体血管化后截肢率为10.2%.
- 患者的年龄和并发性疾病影响截肢风险,这表明在分拣中评估脆弱性.
- 延迟的再血管化增加了截肢的风险,强调了需要迅速,适当的分类高风险伤害的肢体救援.
相关概念视频
Peripheral Artery Disease V: Postoperative Nursing Management
28
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
28
Peripheral Artery Disease III: Interprofessional Care
32
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
32
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
38
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
38
Venous Thrombosis III: Interprofessional Care
26
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
26
Venous Thrombosis IV: Nursing Management
25
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
25
Factors Affecting the Risk of Infection
12.3K
The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
12.3K


