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脊柱手术围手术期心血管并发症的发生率及危险因素。

Incidence and Risk Factors for Perioperative Cardiovascular Complications in Spine Surgery.

机构信息

Department of Anesthesiology, Neurological Institute of Thailand, Bangkok, 10400, Thailand.

出版信息

F1000Res. 2022 Jan 7;11:15. doi: 10.12688/f1000research.75245.2. eCollection 2022.

Abstract

An increasing number of patients are opting for spine surgery despite the associated risk of cardiovascular complications. The evidence regarding the incidence and risk factors of cardiovascular complications in spine surgery is insufficient. Therefore, we aimed to determine the incidence and risk factors for cardiovascular complications that occur perioperatively in spine surgery. This retrospective study included all patients who underwent spine surgery between January 2018 and December 2019 at a single center. Demographic, clinical, and operative data were collected from electronic medical records. The incidence of perioperative cardiac complications was determined. Univariate and multivariate analyses were performed to identify risk factors for the development of perioperative cardiovascular complications in the participants. Of the 1,002 eligible patients enrolled in the study, six developed cardiac complications. Acute myocardial infarction, cardiac arrest, and congestive heart failure occurred in one, two, and three patients, respectively. Risk factors for cardiovascular complications included scoliosis surgery (odds ratios (OR): 18.61; 95% confidence interval (CI): 1.346-257.35) and a history of congestive heart failure (OR: 120.97; 95% CI: 2.12-6898.80). The incidence of perioperative cardiovascular complications in patients who underwent spine surgery was 0.6%. High-risk patients should be closely monitored optimally managed throughout the perioperative period.

摘要

越来越多的患者选择接受脊柱手术,尽管存在心血管并发症的相关风险。然而,有关脊柱手术中心血管并发症的发生率和危险因素的证据尚不充分。因此,我们旨在确定脊柱手术围手术期发生心血管并发症的发生率和危险因素。

这项回顾性研究纳入了 2018 年 1 月至 2019 年 12 月期间在单中心接受脊柱手术的所有患者。从电子病历中收集了人口统计学、临床和手术数据。确定了围手术期心脏并发症的发生率。对参与者发生围手术期心血管并发症的危险因素进行了单因素和多因素分析。

在纳入研究的 1002 名合格患者中,有 6 名发生了心脏并发症。1 名患者发生急性心肌梗死,2 名患者发生心脏骤停,3 名患者发生充血性心力衰竭。心血管并发症的危险因素包括脊柱侧凸手术(比值比(OR):18.61;95%置信区间(CI):1.346-257.35)和充血性心力衰竭病史(OR:120.97;95%CI:2.12-6898.80)。

接受脊柱手术的患者围手术期心血管并发症的发生率为 0.6%。高危患者应在围手术期进行密切监测和最佳管理。

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