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在癌症患者中绘制术后轨迹:来自印度东北部资源有限的环境的观点

Bhavana Kulkarni¹, Laxman Kumar Mahaseth¹, Tanu Anand²

¹Department of Surgical Oncology, Cachar Cancer Hospital and Research Centre (CCHRC), Silchar, India.

JCO global oncology

|July 30, 2025

概括

高急性生理学和慢性健康评估 (APACHE-II) 评分,大量的血液损失和经验较少的外科医生显著预测手术患者的术后结果不佳. 这突出了针对性监测和改善患者护理的关键因素.

科学领域:

关键护理医学关键护理医学
手术结果研究研究.
在瘤学瘤学.

背景情况:

在重症监护中进行术后监测对于患者的治疗结果至关重要,但资源密集.
识别高风险的手术患者对于在重症监护机构有效分配资源至关重要.
了解预后因素可以指导降低术后死亡率和发病率的策略.

研究的目的:

确定预后因素,预测手术后患者的死亡率和发病率.
帮助识别需要密集监测的高风险个体.
为在资源有限的环境中减少死亡率的策略的制定提供信息.

主要方法:

一项队列研究分析了从18岁以上的421名癌症患者的二次数据,这些患者被送往重症监护室.
从电子健康记录中提取术前,术后和术后的参数.
使用STATA v.12进行描述性分析和日志双项回归,以确定不良结果 (发病率或死亡率) 的预测因素.

主要成果:

该研究包括421名患者 (平均年龄为58.02岁),68%的患者经历了显著的术后发病率和3%的死亡率.
预测不良结果的预测因素包括急性生理学和慢性健康评估 (APACHE-II) 评分>15 (RR 4.5),外科医生经验<10年 (RR 1.7) 和输血>100毫升 (RR 2.42).
在研究人口中,烟草使用很普遍 (88%).

结论:

较高的APACHE-II分数,显著的手术期间流血,以及经验较少的外科医生进行手术是不良术后结果的关键决定因素.
这些因素强调了需要在重症监护机构对高风险手术患者进行警的术后监测.
基于这些预后因素的有针对性的干预和资源配置可能会改善患者的生存率并减少并发症.

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