摘要
目的探讨老年患者急诊结直肠手术后的疗效及影响因素,判断高龄(年龄≥80岁)是否为风险因素。方法纳入在医院接受急诊结直肠手术并符合本研究条件老年患者共273例。按年龄分65～79岁157例患者为A组;≥80岁116例患者为B组。结果单变量分析结果显示ASA评分、年龄≥80岁、缺血性临床表现、穿孔性临床表现及缺血性疾病作为风险因素具有统计学意义(P<0.01)。Logistic回归分析结果显示,在A组中只有ASA评分(OR=3.73,95%CI为2.15～6.95)、缺血性疾病(OR=4.21,95%CI为1.29～19.31)为老年患者术后死亡的独立风险因素;在B组中ASA评分(OR=4.11,95%CI为1.39～7.11)也为独立风险因素,同时年龄≥80岁(OR=3.27,95%CI为1.15～9.34)也为老年患者术后死亡的独立风险因素。结论本研究结果表明,年龄≥80岁及ASA评分为老年患者急诊结直肠手术术后死亡的独立风险因素。因此,对于高龄患者(年龄≥80岁)及ASA评分等级较高的老年患者应慎行急诊结直肠手术。
Objective To explore the outcome and risk factors of emergency colorectal surgery in elderly patients. Methods Retrospectively identified patients received operation were receive emergency colorectal surgery. We divided patients into two groups according to age, and the patients whose age was（66-80）year were defined as A group and the patients whose age was older than 80 were defined as B group. Results Univariate analysis of risk factors for mortality showed that age≥80 years, ASA classification , presentation such as ischaemia and perforation and ischaemic disease of the colon, reached statistical significance. However, only age with OR=3.27 （95% CI： 1.15 - 9.34）, ASA classification with OR=3.73 （95% CI： 2.15-6.95） and colonic ischaemic disease with OR=4.21 （950//00 CI： 1.29 - 19.31） ,were confirmed as independent risk factors by logistic regression in Group A, ASA classification with OR= 4.11 （95% CI： 1.39 - 7.11） were confirmed as independent risk factors by logistic regression in group B. Conclusion The age≥80 and ASA classification are the independent risk factors for mortality of emergency colorectal surgery in elderly patients.
出处
《西部医学》
2013年第10期1494-1496,共3页
Medical Journal of West China
关键词
老年患者
急诊手术
结直肠手术
风险因素
Elderly patient
Emergency surgery
Colorectal surgery
Risk factor
