Terracciano C A, Iannuzzi C, de Blasio R A, Fuiano R, Gallo C
II Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli, Federico II.
Ann Ital Chir. 1992 Mar-Apr;63(2):147-50.
A prospective study for assessment of operative risk in elderly patients was carried in 1182 adult patients, 14 yrs or more, surgically treated not for urgency during 1985 in six Italian centres. Looking for meaningful relations among prognostic factors and outcome of disease is a relevant topic in biomedical of surgical risk was the use of multiple logistic function. Anamnestic, clinical and surgical variables were "explicative" variables, while occurrence of death and postoperative complications were "response" variables. Multipathology (myocardiosclerosis, respiratory failure) frequently associated with advanced age (greater than 70 yrs) contribute to determine the prognosis in surgery of elderly patient. Stepwise logistic regression model was applied to a set of preoperative and operative factors, five of which were found to significantly correlate with death: nutritional status, renal failure, reintervention, bacterial contamination during surgery, age greater than 70 years. From our data some conclusion may be drown: it is emphasized the major role of surgical factors in affecting the postoperative risk; among clinical variables, renal failure furnishes the most relevant contribution to prognosis; advanced age itself does not substantially affect the surgical risk, its role being confounded by association with other pathologies.
1985年，在意大利的六个中心，对1182名14岁及以上非急诊手术治疗的成年患者进行了一项前瞻性研究，以评估老年患者的手术风险。寻找预后因素与疾病结局之间的有意义关系是生物医学中一个相关的话题，手术风险的评估采用了多元逻辑函数。既往史、临床和手术变量为“解释性”变量，而死亡和术后并发症的发生为“反应”变量。与高龄（大于70岁）经常相关的多种病理情况（心肌硬化、呼吸衰竭）有助于确定老年患者手术的预后。将逐步逻辑回归模型应用于一组术前和手术因素，其中五个因素被发现与死亡显著相关：营养状况、肾衰竭、再次干预、手术期间的细菌污染、年龄大于70岁。从我们的数据中可以得出一些结论：强调了手术因素在影响术后风险方面的主要作用；在临床变量中，肾衰竭对预后的贡献最大；高龄本身并不会实质性地影响手术风险，其作用因与其他病理情况相关而被混淆。
