经过胆囊切除术的肝硬化患者的现实结果:基于人口的研究
Sulaiman Nanji1, Sean Bennett1, Zuhaib M Mir2
1Division of General Surgery, Department of Surgery, Kingston Health Sciences Centre & Queen's University, Kingston, Ontario, Canada.
概括
肝硬化患者的胆囊切除术总体死亡率较低,但晚年,并发症和新出现的手术预测结果更差. 紧急访问和再接收的高率表明有很大的医疗保健需求.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 外科手术的结果
背景情况:
- 肝硬化增加了手术风险,需要评估胆囊切除术的结果.
- 现实世界的数据对于了解这种脆弱人群的外科手术后并发症至关重要.
研究的目的:
- 在肝硬化患者的胆囊切除术后,描述现实世界外科手术后的结果.
- 为了确定术后肝损伤事件 (POLDEs) 和死亡率的预测因素.
主要方法:
- 使用行政卫生数据进行基于人口的回顾性队列研究 (加拿大安大略省).
- 分析了2009年至2018年间接受胆囊切除术的4769名患者.
- 修改Poisson回归以确定POLDE和90天死亡率的预测因素.
主要成果:
- 与代谢功能障碍相关的脂肪性肝病是导致肝硬化的主要病因 (66%).
- 整体并发症率为13%;1.7%经历了POLDEs,1.9%在90天内死亡.
- 较高的MELD-Na得分,年龄较大,与酒精有关的肝硬化,先前去补偿,并发症和新出现的手术预测了不良结果.
结论:
- 虽然整体早期肝脏并发症和死亡率较低,但特定的患者因素 (年龄,并发症,先前去补偿,新出现的手术) 会显著恶化结果.
- 紧急访问和再接收的高率凸显了出院后大量利用医疗保健的情况.
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