在有认知障碍史的老年人群中出现不良术后结果,或者在进行血管外科手术后跌倒
Aditya Safaya1, Ahsan Zil-E-Ali1, Kristine L So1
1Division of Vascular Surgery, Heart and Vascular Institute, Pennsylvania State Milton S. Hershey Medical Center, Hershey, PA.
Journal of vascular surgery
|July 28, 2025
概括
手术前的认知障碍/痴呆症和最近的跌倒显著增加了接受血管手术的老年人30天死亡率和发病率. 识别这些风险因素有助于手术决策和资源分配.
科学领域:
- 老年人手术是一门老年人手术.
- 血管外科手术的结果
- 患者安全 患者安全
背景情况:
- 认知障碍/痴呆症 (CI/D) 和跌倒在老年人中很常见.
- 它们对血管外科手术术术后结果的影响尚未完全阐明.
研究的目的:
- 评估手术前CI/D和跌倒史与65岁以上接受血管外科手术的患者30天后术后结果的相关性.
主要方法:
- 利用了美国外科医生学院2021年国家外科质量改进计划数据库.
- 将7057名患者分为有或没有CI/D或跌倒的组.
- 采用多变量后勤回归来分析30天死亡率,意外返回手术室和非家庭出院.
主要成果:
- 6.5%的患者有CI/D或跌倒史,年龄较大,并具有较高的并发症负担.
- 这一组的结果明显差:30天死亡率 (7.4%对2.1%),返回OR (12.0%对7.7%),和非家庭出院 (35.6%对11.0%).
- 独立预测的CI/D或跌倒增加了死亡率,返回OR和非家庭出院的几率.
结论:
- 术前CI/D和跌倒是老年血管外科手术中不良术后结果的独立预测因素.
- 这些因素应纳入术前风险评估.
- 改进的风险评估可以提高外科手术决策和资源分配.
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