性别和美国麻醉医师协会分级，而非禁食时间，与术后并发症的发生几率相关。
SEX AND ASA CLASSIFICATION, NOT FASTING TIME, ARE ASSOCIATED WITH THE LIKELIHOOD OF COMPLICATIONS IN THE POSTOPERATIVE PERIOD.
机构信息
Pontifícia Universidade Católica de Campinas, Graduate Program in Health Sciences - Campinas (SP), Brazil.
出版信息
Arq Bras Cir Dig. 2024 Oct 28;37:e1820. doi: 10.1590/0102-6720202400027e1820. eCollection 2024.
BACKGROUND
According to the literature, some factors are associated with the development of postoperative complications including surgical approach, smoking, comorbidities, nutritional status, classification of the American Society of Anesthesiologists (ASA), fasting time period, and others. In the case of surgical patients, some factors are important for the assessment of the outcomes.
AIMS
To investigate the factors associated with the likelihood of postoperative complications in surgical patients.
METHODS
A prospective observational study was conducted with patients who were admitted to hospital more than 24 h. The following variables were investigated: nutritional risk screening, body mass index, ASA classification, fasting time, length of hospital stay, and postoperative complications. For statistical analysis, the Chi-square, Fisher's exact, and Mann-Whitney tests were used. To investigate the risk factors associated with postoperative complications, simple and multiple Cox regression analyses were used.
RESULTS
In the total group of patients, there was an association between postoperative complications and men (p=0.0197), surgical risk (ASA) (p=0.0397) and length of hospital stay (p<0001); men showed a risk 2.2 times greater than women for some kind of postoperative complication (p=0.0456; PR=2.167; 95%CI 1.015-4.624). In patients undergoing gastrointestinal surgery, there was an association between postoperative complications and length of hospital stay (p<0001). In patients undergoing other surgeries, there was an association between postoperative complications and length of hospital stay (p<0001) and ASA classification (p=0.0160); ASA classification was considered a factor associated with the probability of postoperative complications (p=0.0335; PR=4.125; 95%CI 1.117-15.237).
CONCLUSIONS
Men in the total group of patients and the ASA 3 or 4 criteria in the group of patients undergoing other surgeries were considered factors associated with the occurrence of complications in the postoperative period.
背景
根据文献，一些因素与术后并发症的发生有关，包括手术入路、吸烟、合并症、营养状况、美国麻醉医师协会（ASA）分类、禁食时间等。对于手术患者，一些因素对于评估手术结果很重要。
目的
调查与手术患者术后并发症发生相关的因素。
方法
对住院超过 24 小时的患者进行前瞻性观察性研究。调查了以下变量：营养风险筛查、体重指数、ASA 分类、禁食时间、住院时间和术后并发症。统计分析采用卡方检验、Fisher 确切检验和 Mann-Whitney 检验。为了调查与术后并发症相关的危险因素，采用了简单和多 Cox 回归分析。
结果
在总患者组中，术后并发症与男性（p=0.0197）、手术风险（ASA）（p=0.0397）和住院时间（p<0001）有关；男性发生某种术后并发症的风险是女性的 2.2 倍（p=0.0456；PR=2.167；95%CI 1.015-4.624）。在接受胃肠道手术的患者中，术后并发症与住院时间有关（p<0001）。在接受其他手术的患者中，术后并发症与住院时间（p<0001）和 ASA 分类（p=0.0160）有关；ASA 分类被认为是与术后并发症概率相关的因素（p=0.0335；PR=4.125；95%CI 1.117-15.237）。
结论
在总患者组中男性和接受其他手术的患者中 ASA 3 或 4 级被认为是术后并发症发生的相关因素。
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