血管外科手术后的重症监护:系统性审查
Kitty H F Wong1, Alex K Murigu1, Gianluca Buongiovanni2
1Department of Vascular Surgery, Bristol Medical School, University of Bristol, Bristol, UK.
The British journal of surgery
|August 12, 2025
概括
血管外科手术后进入重症监护室 (ICU) 没有明显的临床益处,并且与较高的死亡率和成本有关. 需要进一步的研究来了解这些结果并改善患者分层.
科学领域:
- 心血管外科心血管外科
- 关键护理医学 关键护理医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 对于接受血管外科手术的患者,重症监护室 (ICU) 资源的最佳利用仍然是一个不确定的领域.
- 评估ICU入院对临床结果和相关成本的影响对于知情决策至关重要.
研究的目的:
- 系统地审查和评估重症监护室 (ICU) 入院对选择性和紧急血管手术后的临床结果和成本的影响.
主要方法:
- 在2024年7月,在包括MEDLINE,Embase和Cochrane图书馆在内的主要数据库中进行了全面的文献搜索.
- 包括的研究比较了重症监护室 (ICU) 护理与中介或病房医疗护理,用于接受重大血管手术的患者.
主要成果:
- 分析了13项涉及157932名患者的研究. 接受ICU治疗的患者与调整后30天或住院死亡率显著增加有关 (OR 4.14).
- 未经调整的分析表明,接受ICU治疗的患者心血管重大不良事件,急性损伤,需要透析,再入院和严重出血的风险增加.
- 在ICU组中观察到需要机械通风和感染的呼吸衰竭率更高,同时增加了与医院相关的成本.
结论:
- 在血管外科手术后进入重症监护室 (ICU) 时,没有确定确定的临床益处.
- 观察到的结果的潜在原因包括残留的混因素和患者选择中的风险分层不足.
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