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老年急性胆管炎患者临床结局的相关因素。

Factors associated with clinical outcome in geriatric acute cholangitis patients.

机构信息

Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.

出版信息

Eur Rev Med Pharmacol Sci. 2023 Apr;27(8):3313-3321. doi: 10.26355/eurrev_202304_32102.

Abstract

OBJECTIVE

We aimed to determine the risk factors associated with the clinical outcome in cases of acute cholangitis among the geriatric age group.

PATIENTS AND METHODS

Patients aged >65 years hospitalized with the diagnosis of acute cholangitis in an emergency internal medicine clinic were included in this study.

RESULTS

The study population comprised 300 patients. In the oldest-old group, the rates of severe acute cholangitis and intensive care unit hospitalization (39.1% vs. 23.2%, p<0.001) were higher. The mortality rate was also higher in the oldest-old group (10.4% vs. 5.9%, p=0.045). The presence of malignancy, ICU hospitalization, decreased platelet levels, decreased hemoglobin levels, and decreased albumin levels were associated with mortality. In the multivariable regression model in which variables associated with Tokyo severity were included, the associated factors for membership in the severe risk group compared to the moderate risk group were decreased platelet count (OR: 0.96; p=0.040) and decreased albumin level (OR: 0.93; p=0.027). Increasing age (OR: 1.07; p=0.001), malignancy etiology (OR: 5.03; p<0.001), increasing Tokyo severity (OR: 7.61; p<0.001), and decreasing lymphocyte count (OR: 0.49; p=0.032) were determined to be associated with ICU admission. Decreasing albumin levels (OR: 0.86; p=0.021) and ICU admission (OR: 16.43; p=0.008) were determined to be factors associated with mortality.

CONCLUSIONS

Worse clinical outcomes occur among geriatric patients with increasing age.

摘要

目的

本研究旨在确定老年急性胆管炎患者的临床转归的相关危险因素。

方法

本研究纳入了在急诊内科诊所因急性胆管炎住院的年龄>65 岁的患者。

结果

本研究人群共 300 例患者。在高龄组中,重症急性胆管炎和重症监护病房(ICU)住院的发生率更高(39.1%比 23.2%,p<0.001)。高龄组的死亡率也更高(10.4%比 5.9%,p=0.045)。存在恶性肿瘤、ICU 住院、血小板计数降低、血红蛋白水平降低和白蛋白水平降低与死亡率相关。在多变量回归模型中,纳入与东京严重程度相关的变量,与中危组相比,重症风险组的相关因素为血小板计数降低(OR:0.96;p=0.040)和白蛋白水平降低(OR:0.93;p=0.027)。年龄增加(OR:1.07;p=0.001)、恶性肿瘤病因(OR:5.03;p<0.001)、东京严重程度增加(OR:7.61;p<0.001)和淋巴细胞计数降低(OR:0.49;p=0.032)与 ICU 入住相关。白蛋白水平降低(OR:0.86;p=0.021)和 ICU 入住(OR:16.43;p=0.008)与死亡率相关。

结论

老年患者随着年龄的增加,临床转归较差。

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