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老年(80 岁以上)良性疾病患者甲状腺手术围手术期风险评估费用增加。

Increased costs of perioperative risk assessment for thyroid surgery in elderly people (over 80 years) presenting with benign disease.

机构信息

Department of Pathology, University of Pisa, Pisa, Italy.

出版信息

Langenbecks Arch Surg. 2013 Apr;398(4):525-30. doi: 10.1007/s00423-013-1075-4. Epub 2013 Apr 4.

Abstract

BACKGROUND/OBJECTIVES: Evaluate how surgical treatment of benign thyroid disease in elderly people is prone to induce an increase of costs in the next future due to the aging process of the population.

METHODS

A retrospective analysis has been performed on a total of 116 patients operated between January 2007 and September 2011, divided in a group of 58 patients aged over 80 years (Group A) and 58 patients younger than 80 years (Group B). The analyzed data included age, preoperative diagnosis, severe co-morbidities, procedures other than standard needed to evaluate anaesthesiological risk, postoperative hospital stay, complications, duration of postoperative intensive care monitoring, pathologic characteristics, and costs of anaesthesiological risk assessment.

RESULTS

Statistical analysis of collected data showed that the costs related to perioperative risk assessment (p value < 0.001) and the duration of hospital stay (p value < 0.001) were higher in Group A than in Group B. Instead, surgery-related complications were not statistically different.

CONCLUSIONS

Despite feasibility and safety of modern surgical techniques, indications for surgery in elderly patients affected by benign thyroid disease should be reserved mainly for those patients with severe medical necessity.

摘要

背景/目的:评估老年人良性甲状腺疾病的手术治疗在未来由于人口老龄化过程而导致费用增加的倾向。

方法

对 2007 年 1 月至 2011 年 9 月期间接受手术的 116 例患者进行回顾性分析,分为 80 岁以上患者 58 例(A 组)和 80 岁以下患者 58 例(B 组)。分析的数据包括年龄、术前诊断、严重合并症、评估麻醉风险所需的标准以外的其他程序、术后住院时间、并发症、术后重症监护监测时间、病理特征和麻醉风险评估费用。

结果

收集数据的统计分析显示,A 组围手术期风险评估(p 值<0.001)和住院时间(p 值<0.001)相关费用均高于 B 组。而手术相关并发症无统计学差异。

结论

尽管现代手术技术具有可行性和安全性,但对于患有良性甲状腺疾病的老年患者,手术适应证应主要保留给那些有严重医疗需要的患者。

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