Predictors of early mortality and readmissions among dialysis patients undergoing lower extremity amputation
Predictors of early mortality and readmissions among dialysis patients undergoing lower extremity amputation
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DOI：
10.1016/j.jvs.2018.03.408
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发表时间：
2018-11-01
影响因子：
4.3
通讯作者：
Habermann, Elizabeth B.
中科院分区：
文献类型：
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作者：
Hickson, LaTonya J.;Rule, Andrew D.;Habermann, Elizabeth B.
目的：透析患者发生下肢截肢(LEA)和术后并发症的风险增加。有限的研究考察了截肢后30天的死亡率和医疗保健使用结果的差异，或与透析患者预后恶化相关的术前因素。我们的目的是检查透析依赖和其他与LEA术后再入院或死亡相关的术前因素。方法：对2012-2013年美国外科医师学会国家外科质量改进计划中接受主要LEA治疗的透析依赖患者和非透析患者进行了一项回顾性队列研究。主要结果包括截肢后30天内死亡和再次入院。结果：在6468名患者中，1166名(18%)依赖于透析。透析队列中黑人(39%比23%)、糖尿病(76%比58%)、膝下截肢(62%比55%)和住院死亡(8%比3%；均P
Objective: Patients receiving dialysis are at increased risk for lower extremity amputations (LEAs) and postoperative morbidity. Limited studies have examined differences in 30-day outcomes of mortality and health care use after amputation or the preoperative factors that relate to worsened outcomes in dialysis patients. Our objective was to examine dialysis dependency and other preoperative factors associated with readmission or death after LEA.Methods: A retrospective cohort study was conducted of dialysis-dependent and nondialysis patients undergoing major LEA in the 2012 to 2013 American College of Surgeons National Surgical Quality Improvement Program. Primary outcomes included death and hospital readmission within 30 days of amputation.Results: Of 6468 patients, 1166 (18%) were dialysis dependent. The dialysis cohort had more blacks (39% vs 23%), diabetes (76% vs 58%), below-knee amputations (62% vs 55%), and in-hospital deaths (8% vs 3%; all P