Katz N M, Ahmed S W, Clark B K, Wallace R B
Department of Surgery, Georgetown University School of Medicine, Washington, DC.
Ann Thorac Surg. 1988 Jun;45(6):656-60. doi: 10.1016/s0003-4975(10)64770-4.
The cardiac surgical data base at Georgetown University Hospital was reviewed for patients operated on between January 1, 1980, and September 30, 1986, to determine predictors of length of postoperative hospitalization. Mortality among the 1,919 operations was 115 (6%). In the study group of 1,804 operations resulting in survival for at least 30 days, the following factors were analyzed: type of operation, age, sex, New York Heart Association (NYHA) Functional Class, urgency of operation, preoperative myocardial infarction (MI), weight, body surface area, hypertension, diabetes mellitus, previous cardiac operation, smoking history, and family history of cardiac disease. The overall mean length of hospitalization was 10.7 +/- 5.6 days. The analyses indicated that valve operation, age less than 30 and greater than 60 years, female sex, NYHA Class IV, urgent operation, preoperative MI 1 to 4 weeks before operation, and diabetes mellitus requiring medical treatment prolonged hospitalization, but generally by only 2 days. Major prolongation of hospitalization was associated with age in the 20- to 30-year and 80- to 90-year brackets. Unexpectedly, heavy body weight and smoking were not predictive.
回顾了乔治敦大学医院心脏外科数据库中1980年1月1日至1986年9月30日期间接受手术的患者资料，以确定术后住院时间的预测因素。1919例手术中的死亡率为115例（6%）。在1804例至少存活30天的手术研究组中，分析了以下因素：手术类型、年龄、性别、纽约心脏协会（NYHA）心功能分级、手术紧迫性、术前心肌梗死（MI）、体重、体表面积、高血压、糖尿病、既往心脏手术史、吸烟史和心脏病家族史。总体平均住院时间为10.7±5.6天。分析表明，瓣膜手术、年龄小于30岁和大于60岁、女性、NYHAⅣ级、急诊手术、术前1至4周发生MI以及需要药物治疗的糖尿病会延长住院时间，但通常仅延长2天。住院时间的大幅延长与20至30岁和80至90岁年龄段的年龄有关。出乎意料的是，体重过重和吸烟并无预测作用。
