脆弱性和营养状况预测了激进囊切除术患者的术后并发症
David E Hinojosa-Gonzalez1, Gal Saffati1, Gustavo Salgado-Garza2
1Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.
概括
脆弱和营养不良增加了激进囊切除术 (RC) 后的并发症和死亡率. 这些因素虽然很重要,但需要更广泛的评估来预测RC患者的外科结果.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术瘤学手术瘤学
- 老年病的医生 老年病的医生
背景情况:
- 激进囊切除术 (RC) 是一项具有重大风险的大型手术.
- 虚弱和营养状况越来越被认为是影响手术结果的关键因素.
- 脆弱性和营养状况对RC并发症的具体影响需要进一步描述.
研究的目的:
- 评估RC接受RC的患者的脆弱性,营养状况和术后结果之间的关系.
- 评估RC并发症的修改脆弱指数-5 (mFI-5) 和营养风险指数 (NRI) 的预测值.
主要方法:
- 美国外科医生学院国家外科质量改进计划数据库的回顾性分析.
- 根据mFI-5评分定义的脆弱性≥2;根据NRI定义的营养不良≤97.5;根据白蛋白定义的低白蛋白血症≤3.5.5.
- 分析的结果包括30天的并发症,停留时间和死亡率.
主要成果:
- 虚弱 (21.6%的患者) 与更高的传染病,心肺和脏并发症率有关,死亡率翻了一番.
- 营养不良 (8.05%) 和低albuminemia (15.2%) 与增加的输血需求和死亡率有关.
- 预测准确性 (AUC 0.53-0.63) 根据结果而异,这表明独立效用有限.
结论:
- 脆弱和营养状况不佳都是RC后不良结果的重要预测因素.
- 这些指数具有适度的预测准确性,应纳入全面的风险评估策略.
- 进一步的研究可能会完善使用脆弱性和营养标记来优化RC患者护理.
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