脆弱和术后结果的关联跨种族和种族
Miguel Gonzalez1, Megan Huisingh-Scheetz2, Johnathan R Kent3
1University of Chicago, Pritzker School of Medicine, 924 E 57th St #104, Chicago, IL, 60637, USA. miguel.gonzalez@uchicagomedicine.org.
Journal of racial and ethnic health disparities
|December 15, 2025
概括
虚弱性显著增加了手术后的死亡率和非家庭出院风险. 然而,它对结果的影响在种族和族群之间存在差异,这表明当前评估工具可能存在偏见.
科学领域:
- 老年人手术是一门老年手术.
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 脆弱性和种族/种族与不良的外科手术结果有关.
- 种族/种族群体之间的脆弱性对外科手术结果的差异影响仍然不清楚.
研究的目的:
- 为了调查虚弱与住院死亡率和非家庭出院的关联是否因老年人接受住院手术而因种族/种族而异.
主要方法:
- 用国家住院患者样本对65岁以上接受重大住院手术 (2016-2018) 的成年人进行回顾性队列研究.
- 使用医院脆弱性风险评分 (HFRS) 评估的脆弱性;脆弱性定义为HFRS ≥5.
- 多变量后勤回归分析了脆弱性,种族/种族和结果之间的关联,并对共变量进行了调整.
主要成果:
- 该队列包括1,716,390次手术;35.0%的人很脆弱.
- 虚弱强烈预测住院死亡率 (OR 5.66) 和非家庭出院 (OR 3.14).
- 黑人,西班牙裔和亚洲患者的脆弱性患病率更高. 脆弱与死亡率的关联在黑人患者中较弱,其与非家庭出院的关联在所有非白人群体中减少.
结论:
- 虚弱和不良的手术结果 (死亡率,非家庭出院) 之间的关联在种族/民族群体之间存在显著差异.
- 这些差异引发了人们对当前脆弱性评估工具在不同患者群体中的公平应用和有效性的担忧.
- 进一步验证各种手术群体的脆弱性评估工具对于准确的外科手术期间风险分层至关重要.
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