肝切除术后的一年死亡率:定义一种新的质量指标
Lily V Saadat1, Debra A Goldman2, Hannah Kalvin2
1Division of Hepatopancreatobiliary, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. saadatl@mskcc.org.
Annals of surgical oncology
|October 28, 2025
概括
十分之一的患者在肝切除术一年之内死亡,这是短期死亡指标无法捕捉到的显著率. 恶性病和重大并发症是影响肝脏手术后1年死亡率的关键因素.
科学领域:
- 肝胆道手术 肝胆道手术
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 肝切除术后的30日和90天死亡率由于手术技术和术后护理的进步而有所改善.
- 然而,长期生存,特别是肝切除术后的第一年内,仍然不太了解.
研究的目的:
- 为了研究肝切除术后的一年生存率.
- 确定与肝脏手术后第一年内死亡相关的临床因素,包括结直肠肝转移 (CRLM) 患者.
主要方法:
- 在1991-2018年间接受肝切除术的6191名成年患者的回顾性分析.
- 使用单变量和多变量逻辑回归分析来确定1年死亡率的预测因素.
- 对一小组接受CRLM肝切除术的患者进行了具体分析.
主要成果:
- 整体1年生存率为89.9%. 对于幸存90天的患者来说,1年生存概率为92.2%.
- 恶性病 (OR:5.82),重大并发症 (OR:2.84) 和开放式手术方法 (OR:2.06) 在整体队列中与1年死亡率有显著关联.
- 在CRLM小组中,重大并发症 (OR:2.94),1年复发 (OR:2.78),多次肝损伤 (OR:2.12) 和B/C肝炎 (OR:3.47) 与1年死亡率有关.
结论:
- 肝切除术后的一年死亡率很大,约影响10%的患者.
- 与短期死亡率不同的是,1年死亡率为术后结果提供了更广泛的视角,包括术后事件和疾病进展.
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