Section of Urology, Department of Surgery, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, NH, Lebanon.
Section of Urology, Department of Surgery, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, NH, Lebanon.
Urology. 2022 Nov;169:23-28. doi: 10.1016/j.urology.2022.06.043. Epub 2022 Aug 9.
To characterize patients at the greatest risk of morbidity and mortality after benign scrotal surgery.
A secondary data analysis was conducted of adults undergoing elective scrotal surgery for benign conditions using 2015-2020 American College of Surgeons National Surgical Quality Improvement data. Patients who experienced a postoperative complication, an unplanned procedure, or who died within 30-days of surgery were identified using the composite outcome "postoperative event". Multiple logistic regression was used to examine the association between patient characteristics and the odds of experiencing a postoperative event.
The study consisted of 12,917 patients, of which 4.1% experienced a postoperative event. After adjustment, malnourishment (OR 4.1, 95% CI: 1.2 - 14.5) decreased functional status (OR 3.8, 95% CI: 2.0 - 7.1), bleeding disorders (OR 3.4, 95% CI: 2.2 - 5.4), age ≥ 40 years (OR 1.6, 95% CI: 1.2 - 2.0), chronic obstructive pulmonary disease, (COPD, OR 1.8, 95% CI: 1.2 - 2.6), smoking (OR 1.4, 95% CI: 1.2 - 1.8), diabetes (OR 1.3, 95% CI: 1.1 - 1.7) and increased body mass index (BMI, OR 1.1, 95% CI: 1.1-1.1) were identified as risk factors for a postoperative event. The risk of a postoperative event was 2.7%, 4.5%, and 11.2% for patients with none, 1 to 2, and > 2 risk factors, respectively.
Complications after benign scrotal surgery are not infrequent. Risk factors include malnourishment, decreased functional status, bleeding disorders, age, COPD, smoking, diabetes, and increased BMI. Our results can be used to counsel patients on their risk of negative outcomes following these procedures.
描述行良性阴囊手术患者的发病率和死亡率最高的风险特征。
对 2015-2020 年美国外科医师学会国家手术质量改进计划数据库中接受择期良性阴囊手术的成年人进行二次数据分析。使用复合结局“术后事件”识别术后发生并发症、非计划手术或术后 30 天内死亡的患者。采用多因素逻辑回归分析患者特征与术后事件发生概率的关系。
本研究共纳入 12917 例患者,其中 4.1%的患者发生术后事件。调整后,营养不良(OR 4.1,95%CI:1.2-14.5)、功能状态下降(OR 3.8,95%CI:2.0-7.1)、出血性疾病(OR 3.4,95%CI:2.2-5.4)、年龄≥40 岁(OR 1.6,95%CI:1.2-2.0)、慢性阻塞性肺疾病(COPD,OR 1.8,95%CI:1.2-2.6)、吸烟(OR 1.4,95%CI:1.2-1.8)、糖尿病(OR 1.3,95%CI:1.1-1.7)和体重指数(BMI)升高(OR 1.1,95%CI:1.1-1.1)被确定为术后事件的危险因素。无、1-2 个和>2 个危险因素的患者术后事件风险分别为 2.7%、4.5%和 11.2%。
良性阴囊手术后并发症并不少见。危险因素包括营养不良、功能状态下降、出血性疾病、年龄、COPD、吸烟、糖尿病和 BMI 升高。我们的结果可用于向患者提供这些手术的负面结果风险。