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老年退伍军人急诊腹股沟疝修补术的结果

Outcomes of emergent inguinal hernia repair in veteran octogenarians.

作者信息

Huerta Sergio, Pham Thai, Foster Scott, Livingston Edward H, Dineen Sean

机构信息

University of Texas Southwestern Medical Center/VA North Texas Health Care System, Dallas, Texas.

出版信息

Am Surg. 2014 May;80(5):479-83.

Abstract

Outcomes from emergent inguinal hernia (IH) repair in veteran octogenarians are not well described. We reviewed outcomes for this cohort from 2005 to 2012 at the VA North Texas Health Care System. There were 15 emergent (Group I) and 86 elective (Group II) operations performed in octogenarians. Age and American Society of Anesthesiologists status were similar in both groups. The rate of minor and major complications was higher in Group I compared with Group II (33 and 19% vs 22 and 2%, respectively; both Ps < 0.001). Hospital length of stay (LOS) and intensive care unit LOS were also longer in Group I compared with Group II (6.7 ± 7.0 and 2.5 ± 4.4 vs 0.8 ± 1.9 and 0.12 ± 0.6 days, respectively; both Ps < 0.001). Thirty-day mortality was 13 per cent for Group I and 0 per cent for Group II. Despite the high rate of comorbid conditions in our group, the risk associated with elective repair of IH was not prohibitive. In contrast, we observed that 15 per cent of patients presented with an incarcerated hernia during the study period and the mortality rate was 13 per cent in this cohort. Factors that might predict incarceration in veteran octogenarians need to be further investigated.

摘要

老年退伍军人急诊腹股沟疝(IH)修补术的结果尚无详尽描述。我们回顾了2005年至2012年在北德克萨斯州退伍军人医疗保健系统中该队列患者的手术结果。在老年患者中,共进行了15例急诊手术(第一组)和86例择期手术(第二组)。两组患者的年龄和美国麻醉医师协会分级相似。与第二组相比,第一组的 minor 和 major 并发症发生率更高(分别为33%和19%,而第二组为22%和2%;P值均<0.001)。第一组的住院时间(LOS)和重症监护病房住院时间也比第二组长(分别为6.7±7.0天和2.5±4.4天,而第二组为0.8±1.9天和0.12±0.6天;P值均<0.001)。第一组的30天死亡率为13%,第二组为0%。尽管我们组的合并症发生率很高,但择期修补IH的风险并非不可接受。相比之下,我们观察到在研究期间有15%的患者出现嵌顿疝,该队列的死亡率为13%。可能预测老年退伍军人嵌顿疝的因素需要进一步研究。

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