老年人体质指数和手术后的结果
Cecilia Canales1, Myles Anderson1,2, David Elashoff3,4
1Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at University of California, Los Angeles.
JAMA network open
|August 26, 2025
概括
在接受重大选择性手术的老年人中,与正常体重相比,超重与30天死亡风险显著降低. 这些发现挑战了对这一群体的传统体重管理建议.
科学领域:
- 老年医学
- 手术成果研究
- 肥胖与健康问题
背景情况:
- 在一般人群中,高体重指数 (BMI) 与术后并发症的增加有关.
- 衰老和虚弱会改变身体组成,可能会改变老年人BMI与手术结果的关系.
研究的目的:
- 在接受重大选择性手术的老年人中研究更高的BMI和全因死亡率之间的关联.
- 确定老年人群中的手术不良结果的BMI值是否不同.
主要方法:
- 在65岁以上的414名接受重大选择性手术的成年人中进行了观察队列研究.
- 分析30天和1年的全因死亡率,妄想,排泄倾向,和克拉维恩-丁多并发症.
- 主要暴露的是体质指数 (BMI),分为体重不足,正常,超重和肥胖.
主要成果:
- 与正常的BMI (18. 8%) 相比,超重患者 (BMI 25. 0 - 29. 9) 的30天死亡率最低,显著降低 (OR 0. 03).
- 体重不足患者 (BMI < 18. 5) 的30天死亡率最高 (75. 0%).
- 在多变量调整后,体重过重与降低死亡率的关联仍然显著 (OR 0. 14).
结论:
- 在接受重大选择性手术的老年人中,超重与30天死亡风险较低有关.
- 当前的手术前减肥建议可能需要对老年人群进行重新评估,考虑到更高的BMI的潜在好处.
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