接受心脏手术的非老年人中的结果和并发症:一个范围审查

Laurence Weinberg^1,2, Jarryd Ludski¹, Bradly Carp¹

¹Department of Anaesthesia, Austin Health, Heidelberg, Australia.

PloS one

|September 8, 2025

概括

非老年人 (90-99岁) 的开放心脏手术具有很高的风险,平均30天死亡率为10.5%,主要并发症率约为71.4%. 需要进一步的研究,以改善这一老年人群的结果.

科学领域:

心脏病学心脏病学
老年人手术是一门老年手术.
研究成果研究成果研究成果

背景情况:

非老年人 (90-99岁) 代表一个不断扩大的人口群体,接受复杂的医疗干预.
了解开放心脏手术在这个人群中的风险和结果对于临床决策至关重要.

研究的目的:

进行现有证据对接受开放心脏手术的非老年人的结果和并发症的范围审查.
识别有关以患者为中心的结果和风险因素的知识差距.

主要方法:

在MEDLINE,EMBASE和Cochrane控制试验中央注册表中进行系统的文献搜索.
遵守系统审查和元分析 (PRISMA) 扩展范围审查协议的优先报告项目.
包括28项涉及6411名非老年人的研究,没有对研究设计或出版日期的限制.

主要成果:

30天死亡率中位数为10.5%,主要并发症率中位数为71.4%.
常见的术后并发症包括呼吸系统 (19%),心脏 (20%) 和神经系统 (18%).
平均住院时间为12.5天;没有报告有计划外的再入院或详细的以患者为中心的结果的研究.

结论:

非老年人的开放心脏手术与显著的发病率和死亡率有关.
国际登记处非常需要,以识别风险因素并改善结果.
标准化的脆弱性评估和患者报告的结果措施对于优化护理至关重要.

相关概念视频

01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

290

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...

290

01:23

Peripheral Artery Disease V: Postoperative Nursing Management

379

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...

379

01:22

Aneurysm IV: Nursing Management

392

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...

392

01:26

Cardiac Catheterization IV: Nursing Management

661

Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...

661

01:28

Cardiac Catheterization I: Pre-Procedure Overview

1.1K

Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...

1.1K

01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

577

Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...

577