年龄,ASA身体状况和手术结果:来自全国性队列研究的见解
Naima Kilhamn1,2, Jesper Eriksson1,2, Erik von Oelreich1,2
1Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
Anaesthesia
|July 29, 2025
概括
美国麻醉学会 (ASA) 的身体状况与所有年龄段的成年外科患者的术后死亡率密切相关. 更高的ASA状态显著增加了手术后30天和365天内死亡的风险.
科学领域:
- 麻醉学 麻醉学
- 手术风险评估手术风险评估
- 公共卫生 公共卫生
背景情况:
- 全球每年有超过3亿次手术,老年人口患上更多的并发症.
- 术后风险评估至关重要,但在广泛的手术群体中,ASA身体状况和年龄之间的联系需要进一步探索.
研究的目的:
- 研究美国麻醉学会 (ASA) 身体状况,患者年龄和术后死亡率之间的关系.
- 评估ASA身体状况对当代成年手术队列中短期和长期死亡率的预测价值.
主要方法:
- 全国范围的队列研究使用来自瑞典期经营登记册的数据 (2019年1月 - 2023年3月).
- 分析包括18岁或以上接受重大非心脏手术的患者.
- 相关疾病,社会经济因素和死亡率的数据来自国家卫生登记册.
主要成果:
- 分析了超过46万项手术;平均年龄为66岁 (可选) 和68岁 (急性).
- 原始的30天死亡率为0.5% (可选) 和5.4% (急性).
- 经过调整后的分析显示,与ASA 1相比,在较高的ASA身体状况类别 (例如,ASA 3:14倍增加;ASA ≥4:51-62倍增加) 中,30天死亡风险显著增加,无论手术类型如何.
结论:
- ASA的身体状况是成年外科病人的所有年龄段死亡率的强有力的预测指标.
- 这些发现强化了ASA身体状况在外科手术期间风险分层中的重要性,特别是在全球人口老龄化方面.
- 鉴于人口结构的变化和外科手术需求的增加,对风险评估工具的持续评估至关重要.
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