PDF(Pubmed)
Abstract：
UNASSIGNED: To investigate the relationship between intraoperative anesthesia-related factors and postoperative complications in patients undergoing emergency abdominal surgery, and to identify risk factors for these postoperative complications.
UNASSIGNED: We retrospectively analyzed 942 emergency surgery patients who underwent general anesthesia and emergency abdominal operations at Jiangsu Province Hospital during the period September 2015 to December 2016. Logistic regression analysis was performed to analyze the association between preoperative or intraoperative parameters and postoperative complications.
UNASSIGNED: Among the 942 patients whose data were analyzed, 226 (24.0%) had major postoperative complications within 30 days after surgery. The most common postoperative complications were respiratory complications (31.8% of those experiencing complications). After adjusting for the role of multiple confounding factors, multivariable analysis showed that the independent risk factors for postoperative complications were patient age (OR 1.648; 95% CI 1.352-2.008), the ASA classification (OR 3.220; 95% CI 2.492-4.162), intraoperative hypotension lasting more than 20 min (OR 2.031; 95% CI 1.256-3.285), intraoperative tachyarrhythmias (OR 2.205; 95% CI 1.114-4.365), and the surgical level (i.e. type and difficulty level) [OR 1.895; 95% CI 1.306-2.750].
UNASSIGNED: Prolonged intraoperative hypotension (>20 min) and the occurrence of tachyarrhythmias are independent risk factors for postoperative complications in patients who undergo emergency abdominal surgery. During hemodynamic management of these patients, systolic blood pressure should be controlled to within 20% of the baseline value to reduce the risk of postoperative complications. In addition, a higher patient age, higher ASA grade, and a higher surgical classification level also significantly increase the risk of postoperative complications.
UNASSIGNED: We retrospectively analyzed 942 emergency surgery patients who underwent general anesthesia and emergency abdominal operations at Jiangsu Province Hospital during the period September 2015 to December 2016. Logistic regression analysis was performed to analyze the association between preoperative or intraoperative parameters and postoperative complications.
UNASSIGNED: Among the 942 patients whose data were analyzed, 226 (24.0%) had major postoperative complications within 30 days after surgery. The most common postoperative complications were respiratory complications (31.8% of those experiencing complications). After adjusting for the role of multiple confounding factors, multivariable analysis showed that the independent risk factors for postoperative complications were patient age (OR 1.648; 95% CI 1.352-2.008), the ASA classification (OR 3.220; 95% CI 2.492-4.162), intraoperative hypotension lasting more than 20 min (OR 2.031; 95% CI 1.256-3.285), intraoperative tachyarrhythmias (OR 2.205; 95% CI 1.114-4.365), and the surgical level (i.e. type and difficulty level) [OR 1.895; 95% CI 1.306-2.750].
UNASSIGNED: Prolonged intraoperative hypotension (>20 min) and the occurrence of tachyarrhythmias are independent risk factors for postoperative complications in patients who undergo emergency abdominal surgery. During hemodynamic management of these patients, systolic blood pressure should be controlled to within 20% of the baseline value to reduce the risk of postoperative complications. In addition, a higher patient age, higher ASA grade, and a higher surgical classification level also significantly increase the risk of postoperative complications.
摘要：
■探讨急诊腹部手术患者术中麻醉相关因素与术后并发症的关系。并确定这些术后并发症的危险因素。
■我们回顾性分析了2015年9月至2016年12月期间在江苏省人民医院接受全身麻醉和紧急腹部手术的942例急诊手术患者。采用Logistic回归分析术前或术中参数与术后并发症的关系。
■在分析数据的942名患者中，术后30天内有226例(24.0%)出现严重的术后并发症。最常见的术后并发症是呼吸系统并发症（31.8％的并发症）。在调整了多个混杂因素的作用后，多因素分析显示,术后并发症的独立危险因素为患者年龄(OR1.648;95%CI1.352-2.008),ASA分类（OR3.220；95%CI2.492-4.162），术中低血压持续超过20分钟（OR2.031;95％CI1.256-3.285），术中快速性心律失常（OR2.205；95%CI1.114-4.365），和手术水平(即类型和难度水平)[OR1.895;95%CI1.306-2.750]。
■术中低血压（>20分钟）和快速性心律失常的发生是急诊腹部手术患者术后并发症的独立危险因素。在对这些患者进行血流动力学管理期间，收缩压应控制在基线值的20%以内，以降低术后并发症的风险。此外,患者年龄越高，较高的ASA等级，较高的手术分类水平也会显著增加术后并发症的风险。
■我们回顾性分析了2015年9月至2016年12月期间在江苏省人民医院接受全身麻醉和紧急腹部手术的942例急诊手术患者。采用Logistic回归分析术前或术中参数与术后并发症的关系。
■在分析数据的942名患者中，术后30天内有226例(24.0%)出现严重的术后并发症。最常见的术后并发症是呼吸系统并发症（31.8％的并发症）。在调整了多个混杂因素的作用后，多因素分析显示,术后并发症的独立危险因素为患者年龄(OR1.648;95%CI1.352-2.008),ASA分类（OR3.220；95%CI2.492-4.162），术中低血压持续超过20分钟（OR2.031;95％CI1.256-3.285），术中快速性心律失常（OR2.205；95%CI1.114-4.365），和手术水平(即类型和难度水平)[OR1.895;95%CI1.306-2.750]。
■术中低血压（>20分钟）和快速性心律失常的发生是急诊腹部手术患者术后并发症的独立危险因素。在对这些患者进行血流动力学管理期间，收缩压应控制在基线值的20%以内，以降低术后并发症的风险。此外,患者年龄越高，较高的ASA等级，较高的手术分类水平也会显著增加术后并发症的风险。
