A multivariate analysis of the risk of pulmonary complications after laparotomy.
A multivariate analysis of the risk of pulmonary complications after laparotomy.
复制标题
剖腹手术后肺部并发症风险的多变量分析。
作者：
J. Hall;R. Tarala;J. Hall;J. Mander
我们对1,000例接受腹部手术的患者进行了一项前瞻性纵向研究，评估PPC与各种假定危险因素之间的关系。通过将PPC定义为阳性临床结果结合痰微生物阳性、不明原因发热或阳性胸部X线检查结果，排除了一过性亚临床事件。PPC的总发病率为23.2%（232/1,000）。多变量分析确定了7个与PPC相关的因素：阿萨分级大于2，上腹部手术，残余腹腔内脓毒症，年龄大于59岁，BMI大于25，术前住院时间大于4天，结直肠或胃十二指肠手术（总体F评分= 33.5，p <0.0001）。阿萨分级是单变量和多变量分析中最有力的风险指标。阿萨分级大于1和年龄大于59岁的组合确定了88%（205/232）的患者发生PPC。这些发现为临床医生和临床研究者提供了一种简单的方法来识别腹部手术后PPC的高风险患者。
We evaluated the relationship between PPC and various putative risk factors in a prospective longitudinal study of 1,000 patients undergoing abdominal surgery. Transient subclinical events were excluded by defining PPC as positive clinical findings in combination with either positive sputum microbiology, unexplained pyrexia, or positive chest roentgenographic findings. The overall incidence of PPC was 23.2 percent (232/1,000). Multivariate analysis identified seven factors which were associated with PPC: ASA classification greater than 2, upper abdominal surgery, residual intraperitoneal sepsis, age greater than 59 years, BMI greater than 25, preoperative hospital stay greater than 4 days, and colorectal or gastroduodenal surgery (overall F score = 33.5, p less than 0.0001). The ASA classification was the most powerful indicator of risk in both the univariate and the multivariate analyses. The combination of ASA classification greater than 1 and age greater than 59 years identified 88 percent (205 of 232) of the patients who developed PPC. These findings provide clinicians and clinical investigators with a simple means of identifying patients who are at high risk of PPC after abdominal surgery.
间歇性正压呼吸、激励性肺量测定和深呼吸练习预防腹部手术后肺部并发症的对照试验。
DOI：
10.1164/arrd.1984.130.1.12
发表时间：
1984
期刊：
The American review of respiratory disease
影响因子：
--
作者：
Celli,BR;Rodriguez,KS;Snider,GL
通讯作者：
Snider,GL