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2005 - 2012年国家外科质量改进计划中孕妇非产科手术后的并发症

Postoperative complications after non-obstetric surgery among pregnant patients in the National Surgical Quality Improvement Program, 2005-2012.

作者信息

Abdelwahab Mahmoud, Lynch Courtney D, Schneider Patrick, Thung Stephen, Costantine Maged M, O'Malley David, Landon Mark B, Pawlik Tim M, Venkatesh Kartik K

机构信息

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, USA.

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, USA.

出版信息

Am J Surg. 2022 Feb;223(2):364-369. doi: 10.1016/j.amjsurg.2021.04.002. Epub 2021 Apr 10.

Abstract

BACKGROUND

To examine whether pregnant patients have higher risk of major 30-day postoperative complications compared with their non-pregnant counterparts after non-obstetric surgery.

METHODS

A secondary analysis of the prospective National Surgical Quality Improvement Program (NSQIP) from 2005 to 2012 of pregnant patients 18-51 years old, without surgery in the preceding 30 days, and who underwent a non-obstetrical operation. The primary outcome was composite 30-day major postoperative complications. We used modified Poisson regression.

RESULTS

Among 354,251 assessed patients, 3655 (1%) were pregnant. The overall incidence of 30-day major postoperative complication was 6%, and did not vary by pregnancy status. Pregnant patients were not at higher risk of 30-day major postoperative complications compared to non-pregnant patients following non-obstetric surgery. This held for most procedures, except pregnant patients were at a higher risk of complications with colorectal and hernia surgeries. Secondarily, pregnant patients were at higher risk of transfusion.

CONCLUSIONS

Pregnant patients are generally not at higher risk of major postoperative complications following non-obstetric surgery. This information can be used when counseling pregnant patients about the risks versus benefits of non-obstetric surgery.

摘要

背景

探讨非产科手术后,与非孕患者相比,孕龄患者术后30天发生主要并发症的风险是否更高。

方法

对2005年至2012年前瞻性全国外科质量改进计划(NSQIP)进行二次分析,纳入年龄在18至51岁之间、前30天内未接受手术且接受非产科手术的孕龄患者。主要结局为术后30天主要并发症的综合情况。我们采用修正泊松回归分析。

结果

在354,251例评估患者中,3655例(1%)为孕龄患者。术后30天主要并发症的总体发生率为6%,且不受妊娠状态影响。非产科手术后,与非孕患者相比,孕龄患者术后30天发生主要并发症的风险并未更高。大多数手术均如此,但孕龄患者接受结直肠手术和疝气手术时并发症风险较高。其次,孕龄患者输血风险较高。

结论

非产科手术后,孕龄患者一般不会面临更高的术后主要并发症风险。该信息可用于为孕龄患者提供非产科手术风险与益处的咨询。

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