The effects of pre-existing dementia on surgical outcomes in emergent and nonemergent general surgical procedures: assessing differences in surgical risk with dementia.
The effects of pre-existing dementia on surgical outcomes in emergent and nonemergent general surgical procedures: assessing differences in surgical risk with dementia.
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DOI：
10.1186/s12877-018-0844-x
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发表时间：
2018-07-03
期刊：
影响因子：
4.1
通讯作者：
Kassahun WT
中科院分区：
文献类型：
--
作者：
Kassahun WT
目的是评估与非痴呆患者在急诊和非急诊普通外科手术后的结局相比，既存痴呆患者的手术发病率和住院死亡率。共有120名痴呆患者在性别和手术类型方面与120名没有痴呆的患者相匹配，这些患者来自15，295名接受手术的患者，以评估痴呆手术风险的差异。检查患者信息，包括性别、体重指数（BMI）、入院时个体合并症的患病率以及可能与术后结局相关的其他几个变量（作为潜在混杂因素）。与未患痴呆症的患者相比，痴呆症患者的总体并发症负担往往更高。每例患者的平均并发症数量更高（3.30 vs 2.36）和综合并发症指数的平均评分更高（48.61 vs 37.60）证明了这一点，两组之间的差异具有统计学意义。痴呆患者的总体住院死亡率为28.3%（120例患者中有34例死亡）。在同一时期，在我们医院，对照组的总体住院死亡率为20%（120例患者中有24例死亡）。有和无痴呆的患者组分别有3和5个相关的发病风险因素和9和12个死亡风险因素。患有痴呆症的患者术后早期死亡的风险高于平均水平，其致命并发症的发生率高于无痴呆症的手术患者。
The aim was to assess the morbidity and in-hospital mortality that occur in surgical patients with pre-existing dementia compared with those outcomes in non-dementia patients following emergent and nonemergent general surgical operations. A total of 120 patients with dementia were matched for sex and type of surgery with 120 patients who did not have dementia, taken from a cohort of 15,295 patients undergoing surgery, in order to assess differences in surgical risk with dementia. Patient information was examined, including sex, body mass index (BMI), prevalence of individual comorbidities at admission, and several other variables that may be associated with postoperative outcomes as potential confounders. Patients with dementia tended to have a higher overall complication burden compared to those without. This was evidenced by a higher average number of complications per patient (3.30 vs 2.36) and a higher average score on the comprehensive complication index (48.61 vs 37.60), values that were statistically significant for a difference between the two groups. The overall in-hospital mortality in patients with dementia was 28.3% (34 deaths out of 120 patients). During the same period, at our hospital, the overall in-hospital mortality in the control group was 20% (24 deaths out of 120 patients). Patient groups with and without dementia each had 3 and 5 associated risk factors for morbidity and 9 and 12 risk factors for mortality, respectively. Patients with pre-existing dementia have a greater than average risk of early death after surgery, and their incidence of fatal complications is higher than that of surgical patients without dementia.
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影响因子：
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