老年乳腺癌患者的短期术后结局
Short-term, postoperative breast cancer outcomes in patients with advanced age.
作者信息
Pettke Erica, Ilonzo Nicole, Ayewah Martha, Tsantes Sara, Estabrook Alison, Ma Aye Moe Thu
机构信息
Department of Surgery, Mount Sinai St. Luke's and Mount Sinai West Hospitals, 1000 10th Ave Suite 2B, New York, NY, USA.
Department of Surgery, Mount Sinai St. Luke's and Mount Sinai West Hospitals, 1000 10th Ave Suite 2B, New York, NY, USA.
出版信息
Am J Surg. 2016 Oct;212(4):677-681. doi: 10.1016/j.amjsurg.2016.06.007. Epub 2016 Jul 18.
BACKGROUND
This study compares early postoperative breast cancer outcomes between patients 80 years and older (older patients) and those younger than 80 years (<80 years).
METHODS
The National Surgical Quality Improvement Program database was used to identify patients who had breast surgery between 2005 and 2013 for malignancy.
RESULTS
Older patients had a significantly higher percentage of comorbidities and partial mastectomies. Postoperatively, they had higher rates of pneumonia, urinary tract infection, cardiac arrest, and mortality but had lower rates of wound dehiscence, deep wound, and organ space infections. Thirty-day mortality is independently associated with hypertension, coronary artery disease, American Society of Anesthesiology class IV, and older age.
CONCLUSIONS
The overall perioperative morbidity and mortality after breast surgery, regardless of age, is low. Older patients had a significantly higher rate of mortality and systemic complications but a lower rate of wound complications, likely because of less invasive surgical procedures.
背景
本研究比较了80岁及以上患者（老年患者）与80岁以下患者（<80岁）术后早期乳腺癌的治疗结果。
方法
利用国家外科质量改进计划数据库，确定2005年至2013年间因恶性肿瘤接受乳房手术的患者。
结果
老年患者的合并症和部分乳房切除术的比例显著更高。术后，他们发生肺炎、尿路感染、心脏骤停和死亡的几率更高，但伤口裂开、深部伤口和器官腔隙感染的几率更低。30天死亡率与高血压、冠状动脉疾病、美国麻醉医师协会IV级以及高龄独立相关。
结论
无论年龄大小，乳房手术后围手术期的总体发病率和死亡率都较低。老年患者的死亡率和全身并发症发生率显著更高，但伤口并发症发生率更低，这可能是由于手术侵入性较小。
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