Duch Patricia, Møller Morten Hylander
Anæstesiologisk Afdeling, Hvidovre Hospital, Kettegård Allé 30, 2650 Hvidovre, Denmark.
Dan Med J. 2015 Mar;62(3).
The aim of the present nationwide Danish cohort study was to examine the association between body mass index (BMI) and reoperation in patients who are sur-gically treated for perforated peptic ulcer (PPU).
This was a nationwide cohort study of all Danish patients who were surgically treated for benign gastric or duodenal PPU between 2011 and 2013.
reoperation within 30 days of the primary surgical procedure and 90-day survival. The association between BMI and reoperation are presented as crude and adjusted odds ratios (OR) with 95% confidence intervals (CIs).
A total of 726 patients were included. The median age was 69.5 years (range: 18.2-101.7 years), 51.4% were women (n = 373), 78.4% (n = 569) of the patients had at least one co-existing disease, and 47.5% (n = 345) were categorised as American Society of Anesthesiologists (ASA) class ≥ 3. Re-operative surgery was done in 124 patients (17.1%). No statistically significant adjusted association between underweight, overweight or obesity and re-operation was found (adjusted OR (95% CI): 0.456 (0.181-1.148), 1.468 (0.857-2.517), and 1.314 (0.663-2.601), respectively). Patients undergoing reoperative surgery had a statistically significantly lower crude 90-day survival than patients without need of reperative surgery; 63.9% (83/124) versus 75.9% (457/602), p = 0.037.
In the present nationwide cohort study of PPU patients, no statistically significantly adjusted correlation between BMI and re-operation rates was found. Patients undergoing reoperative surgery had a decreased 90-day survival.
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本丹麦全国性队列研究的目的是探讨体重指数（BMI）与接受手术治疗的穿孔性消化性溃疡（PPU）患者再次手术之间的关联。
这是一项对2011年至2013年间接受良性胃或十二指肠PPU手术治疗的所有丹麦患者进行的全国性队列研究。
初次手术30天内再次手术及90天生存率。BMI与再次手术之间的关联以粗比值比和调整后比值比（OR）及95%置信区间（CI）表示。
共纳入726例患者。中位年龄为69.5岁（范围：18.2 - 101.7岁），51.4%为女性（n = 373），78.4%（n = 569）的患者至少有一种并存疾病，47.5%（n = 345）被归类为美国麻醉医师协会（ASA）分级≥3级。124例患者（17.1%）接受了再次手术。未发现体重过轻、超重或肥胖与再次手术之间存在统计学上显著的调整后关联（调整后OR（95%CI）分别为：0.456（0.181 - 1.148）、1.468（0.857 - 2.517）和1.314（0.663 - 2.601））。接受再次手术的患者其粗90天生存率在统计学上显著低于无需再次手术的患者；分别为63.9%（83/124）和75.9%（457/602），p = 0.037。
在本PPU患者的全国性队列研究中，未发现BMI与再次手术率之间存在统计学上显著的调整后相关性。接受再次手术的患者90天生存率降低。
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