Elamin Abubaker, Sinan Laith, Tari Seyedh Paniz H, Ahmad Bilal I
General Surgery, Humanitas University, Milan, ITA.
Otolaryngology, Nottingham University Hospitals, Nottingham, GBR.
Cureus. 2023 Aug 24;15(8):e44031. doi: 10.7759/cureus.44031. eCollection 2023 Aug.
Emergency general surgery (EGS) encompasses a wide range of acute surgical conditions that pose significant risks to patient life and well-being. Understanding the factors that contribute to short-term complications in geriatric patients undergoing EGS is crucial for improving patient outcomes. This retrospective single-center cohort study aimed to evaluate the impact of various variables on short-term complications in geriatric patients undergoing EGS.
A total of 212 patients aged 65 and above who underwent emergency abdominal surgery between 2017 and 2018 were included in the study. The analysis focused on several variables, including age, sex, body mass index (BMI), beta-blocker use, open abdomen treatment, blood transfusions, anticoagulant therapy, and vasopressor use. Univariate and multivariate analyses were conducted to assess the association between these variables and short-term complications.
Among the analyzed variables, blood transfusions and vasopressor use demonstrated a statistically significant association with short-term complications. Patients who received blood transfusions had a significantly higher risk of complications, with an odds ratio (OR) of 3.01 (95% confidence interval, CI: 1.28-7.06, p-value = 0.011). Similarly, the use of vasopressors was strongly correlated with increased short-term complications, with an OR of 14.61 (95% CI: 4.86-43.89, p-value < 0.001).
These findings emphasize the importance of minimizing blood transfusions and careful consideration of vasopressor use in geriatric patients undergoing EGS to reduce the risk of short-term complications. Further research is warranted to explore additional factors and optimize perioperative management strategies to improve outcomes in this vulnerable patient population.
急诊普通外科(EGS)涵盖了一系列对患者生命和健康构成重大风险的急性外科疾病。了解老年患者接受急诊普通外科手术时导致短期并发症的因素对于改善患者预后至关重要。这项回顾性单中心队列研究旨在评估各种变量对老年患者接受急诊普通外科手术时短期并发症的影响。
本研究纳入了2017年至2018年间接受急诊腹部手术的212名65岁及以上患者。分析集中在几个变量上,包括年龄、性别、体重指数(BMI)、β受体阻滞剂的使用、开腹治疗、输血、抗凝治疗和血管升压药的使用。进行单因素和多因素分析以评估这些变量与短期并发症之间的关联。
在分析的变量中,输血和血管升压药的使用与短期并发症存在统计学上的显著关联。接受输血的患者并发症风险显著更高,比值比(OR)为3.01(95%置信区间,CI:1.28 - 7.06,p值 = 0.011)。同样,血管升压药的使用与短期并发症增加密切相关,OR为14.61(95% CI:4.86 - 43.89,p值 < 0.001)。
这些发现强调了在老年急诊普通外科手术患者中尽量减少输血以及谨慎考虑使用血管升压药以降低短期并发症风险的重要性。有必要进行进一步研究以探索其他因素并优化围手术期管理策略,以改善这一脆弱患者群体的预后。