Risk factors for pulmonary complications after spine surgery.
Risk factors for pulmonary complications after spine surgery.
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DOI：
10.1055/s-0028-1100911
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发表时间：
2010-08-01
期刊：
影响因子：
--
通讯作者：
Lee, Michael J
中科院分区：
文献类型：
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作者：
Imposti, Felix;Cizik, Amy;Lee, Michael J
研究设计：前瞻性收集数据的登记研究目的：确定脊柱外科手术中肺部并发症的危险因素。方法：脊柱末端结果登记2003-2004年是一个详尽的数据库，包含1,592例在华盛顿大学医学中心或Harborview医学中心接受脊柱手术的患者。前瞻性记录患者人口统计学、医学合并症、合并症、手术侵入性和不良结局的详细信息。主要结局指标是术后肺部并发症的发生率。确定了每个风险因素的单变量相对风险和95%置信区间。多变量对数二项回归分析，以调查每个危险因素和肺部并发症之间的关联，同时控制其他重要的危险因素。结果：总共有199例脊柱手术后肺部并发症。脊柱手术后呼吸系统并发症的累积发生率为9%（144例患者）。多因素分析表明，性别，慢性阻塞性肺疾病，充血性心力衰竭，糖尿病，年龄，诊断，手术侵入性和手术在胸椎是显着的危险因素，肺部并发症后脊柱surgery.CONCLUSIONS：本研究的结果表明，许多统计学显着的危险因素脊柱手术后肺部并发症。这些结果可能有助于临床医生进行术前风险分层和患者咨询。[表：见正文]不同类别证据的定义见第73页。
STUDY DESIGN: Registry study with prospectively collected data Objective: To determine risk factors for pulmonary complications in spine surgery.METHODS: The Spine End RESULTS Registry 2003-2004 is an exhaustive database of 1,592 patients who underwent spine surgery at the University of Washington Medical Center or Harborview Medical Center. Detailed information regarding patient demographic, medical comorbidity, and comorbidities, surgical invasiveness and adverse outcomes were prospectively recorded. The primary outcome measure was the occurrence of a pulmonary complication following surgery. Univariate relative risks and 95% confidence intervals for each of the risk factors were determined. Multivariate log binomial regression analysis was performed to investigate the association between each risk factor and a pulmonary complication, while controlling for other important risk factors.RESULTS: Altogether, there were 199 pulmonary complications after spine surgery. The cumulative incidence of a respiratory complication after spine surgery was 9% (144 patients). Multivariate analysis suggested gender, chronic obstructive pulmonary disease, congestive heart failure, diabetes, age, diagnosis, surgical invasiveness and surgery in the thoracic spine are significant risk factors for pulmonary complications after spinal surgery.CONCLUSIONS: The results of the present study suggest numerous statistically significant risk factors for pulmonary complications after spine surgery. These results may aid the clinician with preoperative risk stratification and patient counseling. [Table: see text] The definiton of the different classes of evidence is available on page 73.