大型选择性手术对老年人表现状况的影响:一项前性观察性研究
Francesca Moretto1,2, Martina Fracazzini1, Lorenza Scotti1
1Dipartimento di Medicina Traslazionale Università del Piemonte Orientale Novara Italia.
Health science reports
|November 5, 2025
概括
大型选择性手术对老年人产生影响,近三分之一的人经历功能衰退. 较高的并发病率和出院后的问题是手术后降低表现状态的关键风险因素.
科学领域:
- 老年医学 老年医学
- 外科手术的结果
- 术后护理 术后护理
背景情况:
- 接受重大选择性手术的老年人面临着对其功能和认知状态的风险.
- 评估术后的表现对于管理这一群体的健康结果至关重要.
研究的目的:
- 评估重大选择性手术对老年人的功能和认知状态的影响. 手术后3个月.
- 确定二次结果,如需要护理,再住院,医疗机构和麻醉类型的关联.
主要方法:
- 一项观察性前性队列研究包括169名70岁或以上的患者,他们接受了重大选择性手术.
- 在手术后3个月,使用巴特尔指数 (BI) 评估功能状态和迷你精神状态检查 (MMSE) 评估认知状态.
- 衰退被定义为BI恶化或死亡≥10点,或MMSE减少≥3点.
主要成果:
- 近三分之一 (29%) 的患者经历了功能状态显著下降 (BI 衰退或死亡).
- 在14%的患者中观察到认知能力下降 (MMSE下降).
- 较高的查尔森并发症指数 (CCI) 和出院后的健康问题与功能衰退有关,而CCI和腹腔切除方法与增加对家庭护理或再住院的需求有关.
结论:
- 大型选择性手术可以显著损害老年人的功能状态,特别是那些具有高并发症的人.
- 认知能力下降不太常见,对机构或家庭护理的需求仍然相对较低.
- 识别患有功能衰退风险的患者对于优化术后护理和结果至关重要.
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