在无家可归人口中切断下肢截肢
Rylie O'Meara1, Thomas Quigley2, Akshita Gorantla2
1Division of Vascular Surgery, Northwestern Medicine, Chicago, IL.
Annals of vascular surgery
|November 5, 2025
概括
接受下肢截肢的无家可归患者面临着显著的差异,包括截肢时的年龄较小和术后并发症增加. 针对性干预,如街道医学诊所,对于改善对这一弱势群体的护理至关重要.
科学领域:
- 血管外科 血管外科
- 健康差异 在健康上的差异
- 人口健康 人口健康
背景情况:
- 由于心血管疾病,糖尿病和感染治疗失败,无家可归的人面临较高的下肢截肢风险.
- 这项研究解决了关键的知识差距关于护理差异的无家可归的病人进行截肢.
研究的目的:
- 为了确定在接受下肢截肢手术的住房和非住房患者之间的术前优化和术后结果的差异.
- 为患者管理策略提供信息,并改善高风险的无家可归人群的长期结果.
主要方法:
- 在一个单一机构对1304名经历重大下肢截肢 (2007-2021) 的患者进行了回顾性分析.
- 利用通用估计方程和多变量模型来比较住房和无住房队列之间的结果.
主要成果:
- 没有住所的患者在截肢时更年轻,更有可能是吸烟者,并且在手术前不太可能服用抗血小板或他类药物.
- 没有住所的患者手术前血管图率较低,手术后手术部位感染率较高.
- 没有住房的队列在截肢后经历了显著更长的非行走期 (IRR 0.16).
结论:
- 对于无家可归的患者的下肢截肢的护理和结果存在显著差异.
- 无家可归的患者存在独特的风险因素,经历了较差的术后恢复,包括延迟行走.
- 街头医疗诊所为优化无家可归者的护理和随访提供了一个可行的模式.
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