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老年患者减重手术结局:美国外科医师学会国家外科质量改进计划研究。

Bariatric surgery outcomes in the elderly: an ACS NSQIP study.

机构信息

The University of Minnesota, Minneapolis, MN, USA.

出版信息

J Gastrointest Surg. 2012 Jan;16(1):35-44; discussion 44. doi: 10.1007/s11605-011-1749-6. Epub 2011 Oct 27.

Abstract

INTRODUCTION

Mortality and complications following bariatric surgery occur at acceptable rates, but its safety in the elderly population is unknown. We hypothesized that short-term operative outcomes in bariatric surgery patients ≥65 years would be comparable to younger persons.

METHODS

Patients with a body mass index ≥35 kg/m(2) who underwent bariatric surgery in the 2005-2009 American College of Surgeons National Surgical Quality Improvement Program were identified. Controlling for confounders, multivariate regression was used to predict the impact of age on mortality, major events and prolonged length of stay at 30 days.

RESULTS

We identified 48,378 patients who underwent bariatric procedures between 2005 and 2009. Multivariate regression analysis demonstrated advancing age trended towards predicting mortality, but was not statistically significant. Additionally, patients ≥65 years did not experience higher risk of major complications for either open or laparoscopic procedures. However, patients age ≥65 years were more likely to experience prolonged length of stay for both open and laparoscopic procedures.

CONCLUSION

This multi-hospital study demonstrates older age predicts short-term prolonged length of stay but not major events following bariatric surgery. Older age trends toward predicting mortality, but it is not statistically significant.

摘要

简介

减重手术后的死亡率和并发症发生率处于可接受水平,但老年人行减重手术的安全性尚不清楚。我们假设≥65 岁的减重手术患者的短期手术结果与年轻人相当。

方法

在美国外科医师学会国家外科质量改进计划 2005-2009 年期间,确定了身体质量指数≥35kg/m²并接受减重手术的患者。通过控制混杂因素,多元回归分析用于预测年龄对 30 天死亡率、主要事件和延长住院时间的影响。

结果

我们确定了 2005 年至 2009 年间进行减重手术的 48378 名患者。多因素回归分析表明,年龄的增加趋势预示着死亡率的增加,但无统计学意义。此外,≥65 岁的患者无论是行开放手术还是腹腔镜手术,其主要并发症的风险均无增加。然而,≥65 岁的患者无论是行开放手术还是腹腔镜手术,其住院时间延长的风险均更高。

结论

这项多医院研究表明,老年人预测减重手术后短期住院时间延长,但不能预测主要事件。年龄的增加趋势预示着死亡率的增加,但无统计学意义。

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