脊柱手术术前优化以减少并发症
Preoperative Maximization to Reduce Complications in Spinal Surgery.
作者信息
Maitra Sukanta, Mikhail Christopher, Cho Samuel K, Daubs Michael D
机构信息
Department of Orthopaedic Surgery, UNLV School of Medicine, Las Vegas, NV, USA.
Icahn School of Medicine at Mount Sinai, New York, NY, USA.
出版信息
Global Spine J. 2020 Jan;10(1 Suppl):45S-52S. doi: 10.1177/2192568219882349. Epub 2020 Jan 6.
Abstract
STUDY DESIGN
Invited narrative review.
OBJECTIVES
The aim of this review was to summarize current literature regarding risk factors that surgeons can optimize in the preoperative setting in the spinal surgery patient, in order to reduce complications and improve patient-reported outcomes.
METHODS
Review of the relevant literature by the authors.
RESULTS
Modifiable risk factors identified relative to the patient include obesity, malnutrition/nutrient deficiency, diabetes/hyperglycemia, preoperative anemia, vitamin D/DEXA (dual-energy radiograph absorptiometry), nicotine use/smoking, and opioid use/psychosocial factors.
CONCLUSION
By maximizing a patient's physiological and psychological status prior to elective spine surgery, we may move closer to achieving the goals of value-based care: improving patient-reported outcomes while decreasing the cost of care.
摘要
研究设计
受邀叙述性综述。
目的
本综述的目的是总结当前关于外科医生可在脊柱手术患者术前优化的风险因素的文献，以减少并发症并改善患者报告的结局。
方法
作者对相关文献进行综述。
结果
确定的与患者相关的可改变风险因素包括肥胖、营养不良/营养缺乏、糖尿病/高血糖、术前贫血、维生素D/双能X线吸收测定法、尼古丁使用/吸烟以及阿片类药物使用/心理社会因素。
结论
通过在择期脊柱手术前使患者的生理和心理状态达到最佳，我们可能更接近实现基于价值的医疗目标：改善患者报告的结局，同时降低医疗成本。
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