Department of Surgery, Westchester Medical Center, New York Medical College, 100 Woods Road, Taylor Pavilion, E-348, Valhalla, NY, 10595, USA.
Westchester Medical Center, School of Medicine, New York Medical College, Valhalla, NY, 10595, USA.
Hernia. 2020 Jun;24(3):495-502. doi: 10.1007/s10029-019-02068-7. Epub 2020 Jan 24.
Complex abdominal wall reconstruction (CAWR) has become a common surgical procedure both in non-elderly and elderly patients.
The aim of this study is to analyze the outcomes of the elderly compared to nonelderly undergoing CAWR using propensity score matching.
All patients who underwent CAWR using porcine-derived, non-crosslinked acellular dermal matrix (ADM) (Strattice™) between January 2014 and July 2017 were studied retrospectively. Propensity matched analysis was performed for risk adjustment in multivariable analysis and for one-to-one matching. The outcomes were analyzed for differences in postoperative complications, reoperations, mortality, hospital length of stay and adverse discharge disposition.
One hundred-thirty-six patients were identified during the study period. Non-elderly (aged 18-64 years) constituted 70% (n = 95) and elderly (aged ≥ 65 years) comprised 30% of the overall patient population (n = 41). Seventy-three (56.7%) were females. After adjustment through the propensity score, which included 35 pairs, the surgical site infection (p = 1.000), wound necrosis (p = 1.000), the need for mechanical ventilation (p = 0.259), mortality (p = 0.083), reoperation rate (p = 0.141), hospital length of stay (p = 0.206), and discharge disposition (p = 0.795) were similar.
Elderly patients undergoing CAWR with biological mesh have comparable outcomes with non-elderly patients when using propensity matching score.
复杂腹壁重建（CAWR）已成为非老年和老年患者常见的手术程序。
本研究旨在通过倾向评分匹配分析老年患者与非老年患者行 CAWR 的结果。
回顾性研究了 2014 年 1 月至 2017 年 7 月期间使用猪源性非交联去细胞真皮基质（ADM）（Strattice™）行 CAWR 的所有患者。为了进行多变量分析中的风险调整和一对一匹配，进行了倾向评分匹配分析。分析了术后并发症、再次手术、死亡率、住院时间和不良出院处置的差异。
在研究期间，共确定了 136 例患者。非老年（18-64 岁）占 70%（n=95），老年（≥65 岁）占 30%（n=41）。73 例（56.7%）为女性。经过倾向评分调整，包括 35 对后，手术部位感染（p=1.000）、伤口坏死（p=1.000）、需要机械通气（p=0.259）、死亡率（p=0.083）、再次手术率（p=0.141）、住院时间（p=0.206）和出院处置（p=0.795）相似。
使用倾向评分匹配时，老年患者接受生物补片行 CAWR 的结果与非老年患者相似。
