术后并发症的术前风险关联：对 480 万例 ACS-NSQIP 患者的分析结果。
Associations between preoperative risks of postoperative complications: Results of an analysis of 4.8 Million ACS-NSQIP patients.
机构信息
Surgical Outcomes and Applied Research Programa, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
Surgical Outcomes and Applied Research Programa, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA; Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, CO, USA.
出版信息
Am J Surg. 2022 Jun;223(6):1172-1178. doi: 10.1016/j.amjsurg.2021.11.024. Epub 2021 Dec 2.
BACKGROUND
Surgical Risk Preoperative Assessment System (SURPAS) estimates patient's preoperative risk of 12 postoperative complications, yet little is known about associations between these probabilities- We sought to examine relationships between predicted probabilities.
METHODS
Risk of 12 postoperative complications was calculated using SURPAS and the 2012-2018 ACS-NSQIP database. Pearson correlation coefficients (r) were computed to examine relationships between predicted outcomes. "High-risk" was predicted risk in the 10th decile.
RESULTS
4,777,267 patients were included. 71.1% were not high risk, 10.7% were high risk for 1, and 18.2% were high risk for ≥2 complications. High mortality risk was associated with high risk for pulmonary (r = 0.94), cardiac (r = 0.98), renal (r = 0.93), and stroke (0.96) complications. Patients high-risk for ≥2 complications had the most comorbidities and actual adverse outcomes.
CONCLUSIONS
High preoperative risk for certain postoperative complications had strong correlations. 18.2% of patients were high-risk for ≥2 complications and could be targeted for risk reduction interventions.
背景
手术风险术前评估系统（SURPAS）估计患者术后 12 种并发症的术前风险，但对这些概率之间的关系知之甚少——我们试图研究预测概率之间的关系。
方法
使用 SURPAS 和 2012-2018 年 ACS-NSQIP 数据库计算 12 种术后并发症的风险。计算 Pearson 相关系数（r）以检验预测结果之间的关系。“高危”是指第 10 个十分位数的预测风险。
结果
共纳入 4777267 例患者。71.1%的患者不属于高危，10.7%的患者有 1 种并发症高危，18.2%的患者有≥2 种并发症高危。高死亡率风险与肺部（r=0.94）、心脏（r=0.98）、肾脏（r=0.93）和中风（0.96）并发症的高危相关。有≥2 种并发症高危的患者合并症最多，实际不良结局也最多。
结论
某些术后并发症的高术前风险具有很强的相关性。18.2%的患者有≥2 种并发症的高危，可针对这些患者采取降低风险的干预措施。
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