Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut St, Suite 100, Philadelphia, PA, 19107, USA; Thomas Jefferson University Hospital, Department of Surgery, Division of Esophageal and Thoracic Surgery, 211 South 9th St, Suite 300, Philadelphia, PA, 19107, USA.
Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut St, Suite 100, Philadelphia, PA, 19107, USA; Thomas Jefferson University Hospital, Department of Surgery, Division of Esophageal and Thoracic Surgery, 211 South 9th St, Suite 300, Philadelphia, PA, 19107, USA.
Am J Surg. 2023 Jun;225(6):1056-1061. doi: 10.1016/j.amjsurg.2023.01.012. Epub 2023 Jan 10.
Risk factors for mortality following emergent hiatal hernia (HH) repair in the era of minimally invasive surgery remain poorly defined.
Data was obtained from the National Inpatient Sample (NIS), National Readmissions Database, and National Emergency Department Sample for patients undergoing HH repair between 2010 and 2018. Univariate and multivariate logistic regression analyses reported with odds ratio (OR) and 95% confidence intervals (CI) were performed to identify factors associated mortality.
Via the NIS, mortality rate was 2.2% (147 patients). Via the NEDS, the mortality rate was 3.6% (303 patients). On multivariate analysis, predictors of mortality included age (OR 1.05, CI: 1.04,1.07), male sex (OR 1.49, CI: 1.06,2.11), frailty (OR 2.49, CI: 1.65,3.75), open repair (OR 3.59, CI: 2.50,5.17), and congestive heart failure (OR 2.71, CI: 1.81,4.06).
There are multiple risk factors for mortality after hiatal hernia repair. There is merit to a laparoscopic approach even in emergent settings.
在微创外科时代，食管裂孔疝（HH）急诊修补术后死亡率的危险因素仍未明确。
数据来自于 2010 年至 2018 年期间接受 HH 修补术的国家住院患者样本（NIS）、国家再入院数据库和国家急诊部门样本。采用单变量和多变量逻辑回归分析，报告比值比（OR）和 95%置信区间（CI），以确定与死亡率相关的因素。
通过 NIS，死亡率为 2.2%（147 例）。通过 NEDS，死亡率为 3.6%（303 例）。多变量分析显示，死亡率的预测因素包括年龄（OR 1.05，CI：1.04，1.07）、男性（OR 1.49，CI：1.06，2.11）、虚弱（OR 2.49，CI：1.65，3.75）、开放修复（OR 3.59，CI：2.50，5.17）和充血性心力衰竭（OR 2.71，CI：1.81，4.06）。
HH 修补术后有多种死亡危险因素。即使在紧急情况下，腹腔镜方法也有其价值。
