Liu L, Chen L, Lu Y, Yan H Y, Cui W H
Department of Anesthesiology, Beijing Tian Tan Hospital, Capital Medical University, Beijing 100070, China.
Zhonghua Yi Xue Za Zhi. 2021 Mar 23;101(11):770-775. doi: 10.3760/cma.j.cn112137-20200623-01934.
To investigate early postoperative changes in eosinophils (EOS) and the relationship of postoperative hospital stay and hypoeosinophilia in patients undergoing hip fracture surgery under general or spinal anesthesia. The clinical data of patients who underwent hip fracture surgery at Beijing Tiantan Hospital between April 2014 and November 2017 were retrospectively analyzed. Patients were classified according to whether they received general anesthesia or spinal anesthesia. Univariate regression analysis was used to examine a number of covariates potentially contributed to postoperative hospital stay. Multivariate linear regression was used to analyze the relationship between postoperative day 1 EOS counts and postoperative hospital stay. Interaction and stratified analyses were conducted according to anesthesia methods. A total of 149 patients were included in this study. Thirty-four of them underwent general anesthesia and 115 of them underwent spinal anesthesia. The postoperative day 1 EOS of the general anesthesia group was 0 (0,1.8)×10/L, which was lower than that of the spinal anesthesia group 1.0(0,6.0)×10/L (=3.095, <0.01). After adjusting the confounders of age, gender, American Society of Anesthesiologists (ASA) grade, intraoperative blood loss, intraoperative red blood cell (RBC) transfusion, postoperative day 1 hematocrit (HCT) and white blood cell (WBC), postoperative complications, and the interaction terms for ASA, intraoperative blood loss, intraoperative RBC transfusion and postoperative complications, the negative correlation between postoperative hospital stay and postoperative day 1 EOS level was significant (β=-0.39, 95%:-0.74--0.05, <0.05) in the general anesthesia group. EOS were significantly decreased after surgery in general anesthesia group, and the postoperative hospital stay was negatively correlated with postoperative day 1 hypoeosinophilia.
探讨全身麻醉或脊髓麻醉下行髋部骨折手术患者术后早期嗜酸性粒细胞（EOS）的变化以及术后住院时间与嗜酸性粒细胞减少的关系。回顾性分析2014年4月至2017年11月在北京天坛医院行髋部骨折手术患者的临床资料。根据患者接受全身麻醉或脊髓麻醉进行分类。采用单因素回归分析来检验一些可能影响术后住院时间的协变量。多元线性回归用于分析术后第1天EOS计数与术后住院时间之间的关系。根据麻醉方法进行交互作用和分层分析。本研究共纳入149例患者。其中34例行全身麻醉，115例行脊髓麻醉。全身麻醉组术后第1天EOS为0（0，1.8）×10⁹/L，低于脊髓麻醉组的1.0（0，6.0）×10⁹/L（Z=3.095，P<0.01）。在调整年龄、性别、美国麻醉医师协会（ASA）分级、术中失血、术中红细胞（RBC）输注、术后第1天血细胞比容（HCT）和白细胞（WBC）、术后并发症以及ASA、术中失血、术中RBC输注和术后并发症的交互项等混杂因素后，全身麻醉组术后住院时间与术后第1天EOS水平呈显著负相关（β=-0.39，95%置信区间：-0.74--0.05，P<0.05）。全身麻醉组术后EOS显著降低，术后住院时间与术后第1天嗜酸性粒细胞减少呈负相关。
