在COPD患者中增加食管的早期复发:比较风险分析
William Head1, Divyaam Satija1, Stefanie Rohde1
1Center for Minimally Invasive Surgery, Department of Surgery, The Ohio State University Wexner Medical Center.
概括
慢性阻塞性肺部疾病 (COPD) 增加了早期的副食道修复复复发,但不是呼吸道并发症. 患有COPD的患者早些时候出现了复发,并且在手术后需要更高级的护理.
科学领域:
- 胃肠病学 胃肠病学
- 胸部外科手术 胸部外科手术
- 肺部病理学 肺部病理学
背景情况:
- 慢性阻塞性肺病 (COPD) 与手术风险增加有关.
- 慢性肺炎对准食道修复 (PEHR) 结果的影响尚不清楚.
- 这项研究调查了COPD与PEHR结果的关联,特别是的复发.
研究的目的:
- 评估COPD与选修PEHR后的结果之间的关联.
- 确定COPD是否是PEHR后 Hernia复发的独立风险因素.
- 评估COPD对呼吸道并发症的影响以及PEHR后需要高级护理的需要.
主要方法:
- 从2011-2022年对选用PEHR患者进行的回顾性队列研究.
- 患者被分为COPD和高危非COPD组 (ASA 3-4).
- 使用倾向性得分匹配 (1:1),以早期复发 (<6个月) 为主要结果. 多变量逻辑回归分析了独立的风险因素.
主要成果:
- 分析了62对匹配的对;COPD没有增加呼吸道并发症.
- 慢性肺炎患者的复发时间显著提前 (160 vs. 652天; p=0.01) 和更快的退院到高级护理 (12.9% vs. 1.6%; p=0.038).
- 慢性肺炎独立预测早期复发 (OR4.4;p<0.001),由卡普兰-梅尔分析 (p=0.02) 证实.
结论:
- 慢性肺炎是PEHR后早期复发的独立预测因素.
- 虽然不增加呼吸道并发症,但COPD需要更高水平的护理,并导致更早的复发.
- 结果支持共享决策,并建议使用网状网络来降低COPD患者的复发风险.
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