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年龄只是一个数字:患者年龄不影响骨质疏松性椎体压缩骨折手术后的结果。

Age Is Just a Number: Patient Age Does Not Affect Outcome Following Surgery for Osteoporotic Vertebral Compression Fractures.

作者信息

Gupta Anmol, Cha Thomas, Schwab Joseph, Fogel Harold, Tobert Daniel, Qureshi Sheeraz, Hecht Andrew, Bono Christopher M, Hershman Stuart

机构信息

yIcahn School of Medicine at Mount Sinai, The Mount Sinai Hospital, New York, NY, USA.

Harvard Medical School, 2348Massachusetts General Hospital, Boston, MA, USA.

出版信息

Global Spine J. 2021 Sep;11(7):1083-1088. doi: 10.1177/2192568220941451. Epub 2020 Aug 7.

DOI:10.1177/2192568220941451
PMID:32762371
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8351062/
Abstract

STUDY DESIGN

Retrospective study.

OBJECTIVE

Multiple studies have shown that osteoporotic patients are at an increased risk for medical and surgical complications, making optimal management of these patients challenging. The purpose of this study was to determine the relationship between patient age and the likelihood of surgical complications, mortality, and 30-day readmission rates following surgery for osteoporotic vertebral compression fractures (OVCFs).

METHODS

A retrospective analysis of the American College of Surgeons National Surgery Quality Improvement Project (ACS-NSQIP) database from 2007 to 2014 identified 1979 patients who met inclusion criteria. A multivariate logistic regression analysis was conducted to calculate odds ratios (OR), with corresponding values and 95% confidence intervals, of the relationship between age (treated as a continuous variable) and perioperative mortality, surgical complications, and 30-day readmission rates.

RESULTS

Younger patients were statistically more likely to endure a minor (OR = 0.98; = .002) or major complication (OR = 0.97; = .009). The older a patient was, on the other hand, the higher the likelihood that patient would be readmitted within 30 days of surgery (OR =1.02; = .004). Mortality within the 30-day perioperative period was not statistically correlated with age.

CONCLUSIONS

The impact of age on adverse outcomes following surgery for OVCF is mixed. While younger patients are more likely to endure complications, older patients are more likely to be readmitted within 30 days following surgery. Patient age showed no correlation with mortality rates. In the setting of surgical treatment for an OVCF, a patient's age can help determine the risk of complications and the rate of readmission following intervention.

摘要

研究设计

回顾性研究。

目的

多项研究表明,骨质疏松症患者发生内科及外科并发症的风险增加,这使得对这些患者进行优化管理具有挑战性。本研究的目的是确定患者年龄与骨质疏松性椎体压缩骨折(OVCF)手术后手术并发症、死亡率及30天再入院率之间的关系。

方法

对美国外科医师学会国家外科质量改进项目(ACS-NSQIP)2007年至2014年的数据库进行回顾性分析,确定了1979例符合纳入标准的患者。进行多因素逻辑回归分析,以计算年龄(作为连续变量处理)与围手术期死亡率、手术并发症及30天再入院率之间关系的比值比(OR),以及相应的P值和95%置信区间。

结果

较年轻的患者在统计学上更有可能发生轻微(OR = 0.98;P = .002)或严重并发症(OR = 0.97;P = .009)。另一方面,患者年龄越大,术后30天内再次入院的可能性越高(OR = 1.02;P = .004)。围手术期30天内的死亡率与年龄在统计学上无相关性。

结论

年龄对OVCF手术后不良结局的影响是复杂的。虽然较年轻的患者更有可能发生并发症,但老年患者在术后30天内更有可能再次入院。患者年龄与死亡率无相关性。在OVCF的手术治疗中,患者年龄有助于确定并发症风险及干预后的再入院率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4027/8351062/82390d55bc90/10.1177_2192568220941451-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4027/8351062/eafa6f0a502c/10.1177_2192568220941451-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4027/8351062/82390d55bc90/10.1177_2192568220941451-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4027/8351062/eafa6f0a502c/10.1177_2192568220941451-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4027/8351062/82390d55bc90/10.1177_2192568220941451-fig2.jpg

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本文引用的文献

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J Pediatr Orthop. 2019 Sep;39(8):e636-e640. doi: 10.1097/BPO.0000000000001204.
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Serum albumin levels predict which patients are at increased risk for complications following surgical management of acute osteoporotic vertebral compression fractures.血清白蛋白水平可预测哪些患者在接受急性骨质疏松性椎体压缩性骨折手术治疗后有发生并发症的风险增加。
Spine J. 2019 Nov;19(11):1796-1802. doi: 10.1016/j.spinee.2019.06.023. Epub 2019 Jun 27.
3
Risk factors for conservative treatment failure in acute osteoporotic vertebral compression fractures (OVCFs).
急性骨质疏松性椎体压缩性骨折(OVCFs)保守治疗失败的风险因素。
Arch Osteoporos. 2019 Feb 26;14(1):24. doi: 10.1007/s11657-019-0563-8.
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Using the National Surgical Quality Improvement Project (NSQIP) to Perform Clinical Research in Colon and Rectal Surgery.利用国家外科质量改进项目(NSQIP)开展结直肠外科临床研究。
Clin Colon Rectal Surg. 2019 Jan;32(1):41-53. doi: 10.1055/s-0038-1673353. Epub 2019 Jan 8.
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Percutaneous Vertebroplasty Does Not Increase the Incidence of New Fractures in Adjacent and Nonadjacent Vertebral Bodies.经皮椎体成形术不会增加相邻和非相邻椎体新发骨折的发生率。
Clin Spine Surg. 2019 Mar;32(2):E99-E106. doi: 10.1097/BSD.0000000000000734.
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ACR Appropriateness Criteria Management of Vertebral Compression Fractures.ACR 适宜性标准:椎体压缩性骨折的管理。
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