在紧急腹腔切除术中,虚弱影响所有年龄组的结果
Jefferson A Proaño-Zamudio1, Yasmin Arda1, Teresia M Perkins1
1Division of Trauma, Emergency Surgery & Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Boston, MA, 02114, USA.
这项研究表明,在紧急手术后,老年人的死亡率和并发症显著增加. 较高的虚弱度预示着更糟糕的结果和功能衰退.
科学领域:
- 老年人手术
- 手术成果研究
- 弱点评估
背景情况:
- 在接受紧急手术的老年患者中,虚弱对术后结果的影响尚不完全理解.
- 老年人是易受外科手术后不良事件影响的弱势群体.
研究的目的:
- 在接受紧急腹腔切除术的65岁及以上患者中,量化评估虚弱对术后并发症的影响.
- 研究脆弱性与死亡率,并发症和再入院等结果之间的关联.
主要方法:
- 利用美国外科医生学院2013-2019年国家外科质量改进计划 (ACS-NSQIP) 数据库.
- 鉴定了52,356名65岁以上的急诊腹腔切除术患者.
- 使用修改的脆弱指数 (mFI-5) 测量脆弱性,并通过多变量后勤回归分析结果.
主要成果:
- 较高的虚弱指数得分与30天死亡率,肺炎,尿路感染,呼吸衰竭和急性损伤的增加线性相关.
- 虚弱性也与更高的意外再入院率和更短的存活率有关.
- 患者的中位数年龄为76岁,大多数患者的mFI-5得分在0. 2到0. 5之间.
结论:
- 在接受紧急手术的老年人中,虚弱度的增加显著增加了术后不良结果的风险.
- 虚弱是出院后死亡率,并发症和功能恶化的关键预测因素.
- 这些发现强调了在老年患者手术决策中的脆弱性评估的重要性.
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