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种族、民族与接受开腹手术的癌症患者区域麻醉的使用:一项单中心回顾性队列研究。

Race, ethnicity, and the use of regional anesthesia in cancer patients undergoing open abdominal surgery: A single-center retrospective cohort study.

作者信息

Owusu-Agyemang Pascal, Feng Lei, Porche Vivian H, Williams Uduak U, Cata Juan P

机构信息

Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.

Anesthesiology and Surgical Oncology Research Group, Houston, TX, United States.

出版信息

Front Med (Lausanne). 2022 Aug 18;9:950444. doi: 10.3389/fmed.2022.950444. eCollection 2022.

Abstract

BACKGROUND

Where applicable, regional anesthesia has been shown to be superior to opioid or non-opioid analgesic modalities alone. However, some studies have shown ethnic-based disparities in the use of regional anesthesia in patients undergoing surgical procedures. In this study of patients who had undergone major oncologic surgery, our main objective was to compare the use of regional anesthesia between patients of different ethnicities.

METHODS

A retrospective review of adults who had undergone major open abdominal surgical procedures between 2016 and 2021 was performed. Logistic regression models were used to assess the association between baseline patient characteristics and the use of regional anesthesia.

RESULTS

A total of 4,791 patients were included in the analysis. The median age was 60.5 years [interquartile range, 49, 69], the majority were female (65%), and of American Society of Anesthesiologists Physical Status Class (ASA) 3 (94.7%). Regional anesthesia was used in 2,652 patients (55.4%) and was not associated with race or ethnicity ( = 0.287). Compared to White patients, the odds of regional anesthesia use in other racial/ethnic groups were: Asian {odds ratio (OR) 0.851 [95% confidence interval (CI), 0.660-1.097]; = 0.2125}, Black/African American [OR 0.807 (95% CI, 0.651-1.001); = 0.0508], Hispanic/Latino [OR 0.957 (95% CI, 0.824-1.154); = 0.7676], Other race [OR 0.957 (95% CI, 0.627-1.461); = 0.8376]. In the multivariable analysis, age [OR 0.995 (95% CI, 0.991-1.000); = 0.0309] and female gender [OR 1.231 (95% CI, 1.090-1.390); = 0.0008] were associated with the use of regional anesthesia.

CONCLUSION

In this single-institution retrospective study of adults who had undergone major open abdominal surgery, the use of regional anesthesia was not associated with race or ethnicity. In the multivariable analysis, age and female gender were associated with the use of regional anesthesia.

摘要

背景

在适用的情况下,区域麻醉已被证明优于单独使用阿片类或非阿片类镇痛方式。然而,一些研究表明,接受外科手术的患者在区域麻醉使用方面存在基于种族的差异。在这项针对接受重大肿瘤手术患者的研究中,我们的主要目标是比较不同种族患者区域麻醉的使用情况。

方法

对2016年至2021年间接受重大开放性腹部外科手术的成年人进行回顾性研究。使用逻辑回归模型评估患者基线特征与区域麻醉使用之间的关联。

结果

共有4791名患者纳入分析。中位年龄为60.5岁[四分位间距,49,69],大多数为女性(65%),美国麻醉医师协会身体状况分级(ASA)为3级的占94.7%。2652名患者(55.4%)使用了区域麻醉,且与种族或民族无关(P = 0.287)。与白人患者相比,其他种族/民族群体使用区域麻醉的比值比为:亚洲人{比值比(OR)0.851[95%置信区间(CI),0.660 - 1.097];P = 0.2125},黑人/非裔美国人[OR 0.807(95% CI,0.651 - 1.001);P = 0.0508],西班牙裔/拉丁裔[OR 0.957(95% CI,0.824 - 1.154);P = 0.7676],其他种族[OR 0.957(95% CI,0.627 - 1.461);P = 0.8376]。在多变量分析中,年龄[OR 0.995(95% CI,0.991 - 1.000);P = 0.0309]和女性性别[OR 1.231(95% CI,1.090 - 1.390);P = 0.0008]与区域麻醉的使用相关。

结论

在这项针对接受重大开放性腹部手术成年人的单机构回顾性研究中

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f0d/9433667/eb7c989e67f1/fmed-09-950444-g0001.jpg

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