对于形创伤的新兴腹腔切除术:对脆弱的老年人的手术超出了手术室的范围
Muhammad Haris Khurshid1, Francisco Castillo-Diaz1, Mohammad Al Ma'ani1
1Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona.
在接受急性腹腔切除术的老年形创伤患者的脆弱性与增加的住院死亡率和更长的住院时间有关. 脆弱性评估可以指导术后护理和资源配置,以获得更好的患者结果.
科学领域:
- 创伤外科 手术 创伤外科
- 老年医学 老年医学
- 关键的护理关键的护理
背景情况:
- 衰弱在老年人中很常见,预示着糟糕的结果.
- 经过急性腹腔切除术的老年人形创伤患者代表了一个脆弱的人群.
- 需要特定环境的证据来比较脆弱和非脆弱患者之间的结果.
研究的目的:
- 为了比较脆弱与非脆弱的老年人重创伤患者的新生腹腔切除术的结果.
- 在这个患者队列中确定与脆弱性相关的风险因素.
- 为了告知老年人患有重创伤的术后管理策略.
主要方法:
- 美国外科医生学院创伤质量改善计划 (2017-2021) 的回顾性分析.
- 包括65岁以上的形创伤患者,接受急性腹腔切除术.
- 使用修改过的脆弱指数,分类为脆弱和非脆弱群体;分析住院死亡率,LOS和重大并发症.
主要成果:
- 确定了1655名患者;273名脆弱 (F) 和1382名非脆弱 (NF).
- 两组之间没有损伤特征或腹腔切除术时间的显著差异.
- 在多变量分析中,虚弱患者住院时间 (LOS) 较长,住院死亡率的几率增加 (aOR 1.665,P=0.003).
结论:
- 虚弱是老年人急性腹腔切除术后增加住院死亡率和长期住院LOS的独立预测因素.
- 在介绍时纳入脆弱性评估对于指导术后咨询和资源规划至关重要.
- 脆弱状态显著影响结果,需要量身定制的管理方法.
更多相关视频
08:26Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
04:19Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
相关概念视频
Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Aneurysm IV: Nursing Management
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
Flail Chest-I
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
