背景:我们评估了糖尿病患者下肢开腹搭桥手术后的短期不良结局,并根据患者身高进行了比较。
方法:分析了美国外科医师学会国家外科质量改进计划数据库,以选择当前程序术语代码为35533、35540、35556、35558、35565、35566、35570和35571且诊断为糖尿病的患者。这导致83名患者身高60英寸或更低,在60到72英寸之间的1,084,和211名72英寸高的病人。
结果:在浅表手术部位感染的发展方面,组间没有观察到差异(9.6%对6.4%对5.7%;P=.458),深切口感染(1.2%对1.4%对2.8%;P=.289),脓毒症(2.4%对2.0%对2.8%;P=.751),计划外再操作(19.3%对15.6%对21.8%;P=0.071),或计划外再入院(19.3%对14.8%对17.1%;P=.573)。在伤口破裂的发展中,各组之间观察到显着差异(4.8%对1.3%对4.7%;P=.001)。使用年龄变量对伤口破裂结果进行多元回归分析,性别,种族,种族,高度,体重,目前的吸烟者,和开放性伤口/伤口感染。发现种族(P=0.025)和体重(P=0.003)与伤口破裂独立相关,但身高不是(P=.701)。
结论:这项研究的结果表明,根据患者身高,下肢搭桥手术后的短期不良结局没有显著差异。
BACKGROUND: We evaluated adverse short-term outcomes after open lower-extremity bypass surgery in patients with diabetes mellitus with a comparison performed based on patient height.
METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was analyzed to select patients with Current Procedural Terminology codes 35533, 35540, 35556, 35558, 35565, 35566, 35570, and 35571 and with the diagnosis of diabetes mellitus. This resulted in 83 patients 60 inches or less in height, 1,084 between 60 and 72 inches, and 211 patients 72 inches and taller.
RESULTS: No differences were observed among groups with respect to the development of a superficial surgical site infection (9.6% versus 6.4% versus 5.7%; P = .458), deep incisional infection (1.2% versus 1.4% versus 2.8%; P = .289), sepsis (2.4% versus 2.0% versus 2.8%; P = .751), unplanned reoperation (19.3% versus 15.6% versus 21.8%; P = .071), or unplanned hospital readmission (19.3% versus 14.8% versus 17.1%; P = .573). A significant difference was observed among groups in the development of a wound disruption (4.8% versus 1.3% versus 4.7%; P = .001). A multivariate regression analysis was performed of the wound disruption outcome with the variables of age, sex, race, ethnicity, height, weight, current smoker, and open wound/wound infection. Race (P = .025) and weight (P = .003) were found to be independently associated with wound disruption, but height was not (P = .701).
CONCLUSIONS: The results of this investigation demonstrate no significant differences in short-term adverse outcomes after lower-extremity bypass surgery based on patient height.