Division of Surgical Oncology, Department of General Surgery, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA.
Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA.
Am J Surg. 2023 Jul;226(1):108-114. doi: 10.1016/j.amjsurg.2023.03.012. Epub 2023 Mar 25.
Alzheimer's Disease and Related Dementias (ADRD) may result in poor surgical outcomes. The current study aims to characterize the risk of ADRD on outcomes for patients undergoing colorectal surgery.
Colorectal surgery patients with and without ADRD from 2007 to 2017 were identified using electronic health record-linked Medicare claims data from two large health systems. Unadjusted and adjusted analyses were performed to evaluate postoperative outcomes.
5926 patients (median age 74) underwent colorectal surgery of whom 4.8% (n = 285) had ADRD. ADRD patients were more likely to undergo emergent operations (27.7% vs. 13.6%, p < 0.001) and be discharged to a facility (49.8% vs 28.9%, p < 0.001). After multi-variable adjustment, ADRD patients were more likely to have complications (61.1% vs 48.3%, p < 0.001) and required longer hospitalization (7.1 vs 6.1 days, p = 0.001).
The diagnosis of ADRD is an independent risk factor for prolonged hospitalization and postoperative complications after colorectal surgery.
阿尔茨海默病和相关痴呆症（ADRD）可能导致手术效果不佳。本研究旨在分析 ADRD 对接受结直肠手术患者结局的影响。
通过来自两个大型医疗系统的电子健康记录链接的医疗保险索赔数据，确定了 2007 年至 2017 年间患有和不患有 ADRD 的结直肠手术患者。进行了未调整和调整分析，以评估术后结局。
5926 名患者（中位年龄 74 岁）接受了结直肠手术，其中 4.8%（n=285）患有 ADRD。ADRD 患者更可能接受紧急手术（27.7% vs. 13.6%，p<0.001）和出院到医疗机构（49.8% vs. 28.9%，p<0.001）。经过多变量调整后，ADRD 患者更有可能出现并发症（61.1% vs. 48.3%，p<0.001），需要更长的住院时间（7.1 天 vs. 6.1 天，p=0.001）。
ADRD 的诊断是结直肠手术后住院时间延长和术后并发症的独立危险因素。
