非创伤性下肢大截肢术后死亡率影响因素分析。

IF 1.1 4区 医学 Q3 ORTHOPEDICS Acta orthopaedica et traumatologica turcica Pub Date : 2022-11-01 DOI:10.5152/j.aott.2022.22096
Ali Reisoğlu, Ali Turgut, Mert Filibeli, Mustafa İncesu, Eren Yalçın, Oğulcan Parlar
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引用次数: 1

摘要

目的:本研究的目的是评估影响糖尿病和周围血管疾病患者下肢大截肢术后死亡率的预后因素。方法:在这项回顾性研究中,纳入了2008年1月至2021年1月期间,先前诊断为糖尿病和周围血管疾病并首次进行非创伤性下肢截肢的484例患者(345例男性,139例女性)。患者平均年龄64.2±13.8(20-114)岁。32.4%的患者以外周血管疾病为根本病因,67.6%的患者以糖尿病为病因。68.8%的患者行膝下截肢,2.9%的患者行双侧膝下截肢,27.1%的患者行膝上截肢,1.2%的患者行髋关节脱臼。记录患者的性别、年龄、截肢程度、截肢病因、Charlson合并症指数、是否需要输血,以及血红蛋白、血小板、白蛋白、红细胞沉降率、c反应蛋白、钠、钾、中性粒细胞与淋巴细胞比值等实验室检查结果。患者分为死亡≤1个月、≤3个月、≤6个月、≤12个月或存活。结果:高龄、女性、高Charlson合病指数、输血需求、近端截肢水平、术前低血小板、术前低白蛋白、出院时低血红蛋白、低红细胞沉降率、高钠、低血小板、低白蛋白、高c反应蛋白、高中性粒细胞/淋巴细胞比值等参数对1个月、3个月、6个月死亡率的影响均有统计学意义。术后12个月。术前高c反应蛋白对术后1、3个月死亡率的影响有统计学意义,而低c反应蛋白对术后6个月死亡率的影响有统计学意义。出院时的高钾与术后6个月和12个月的死亡率相关。结论:本研究表明,出院时可修改的血红蛋白、钠、钾、血小板、白蛋白等参数对死亡率有影响,出院前将这些参数正常化可降低术后死亡率。证据等级:IV级,预后研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Analysis of the factors affecting mortality after non-traumatic major lower extremity amputations.

Objective: The aim of this study was to evaluate the prognostic factors affecting mortality after major lower extremity amputations in patients with diabetes mellitus and peripheral vascular disease.

Methods: For this retrospective study, 484 patients (345 male, 139 female) who were previously diagnosed with diabetes mellitus and peripheral vascular disease and underwent first-time nontraumatic major lower extremity amputations between January 2008 and January 2021 were included. The mean age of the patients was 64.2 ± 13.8 (20-114). In 32.4% of patients, peripheral vascular disease was the underlying cause, whereas diabetes mellitus was responsible for the etiology in 67.6% of patients. About 68.8% of patients had below-knee amputations, whereas 2.9% had bilateral below-knee amputations, 27.1% had above-knee amputations, and 1.2% had hip disarticulation performed. Gender, age, amputation level, amputation etiologies, Charlson comorbidity index, need for blood transfusion, and laboratory findings such as hemoglobin, platelet, albumin, erythrocyte sedimentation rate, C-reactive protein, sodium, potassium, and neutrophil to lymphocyte ratio levels were recorded preoperatively and at the time of discharge. Patients were grouped as died ≤1 month, ≤3 months, ≤6 months, and ≤12 months or alive.

Results: Advanced age, female gender, high Charlson comorbidity index, blood transfusion requirement, proximal amputation level, preoperative low platelet, preoperative low albumin, and parameters such as low hemoglobin, low erythrocyte sedimentation rate, high sodium, low platelet, low albumin, high C-reactive protein, and high neutrophil to lymphocyte ratio at time of discharge were seen to have a statistically significant effect on mortality at 1 month, 3 months, 6 months, and 12 months postoperatively. Preoperative high C-reactive protein had a statistically significant effect on mortality at 1 and 3 months postoperatively, whereas low C-reactive protein had a statisti cally significant effect on mortality at 6 months postoperatively. High potassium at the time of discharge was associated with mortality at 6 and 12 months postoperatively.

Conclusion: This study has shown us that mortality rates are affected by modifiable parameters at the time of discharge such as hemoglo bin, sodium, potassium, platelet, and albumin, and normalization of these parameters before discharge could reduce the rates of mortality in the postoperative period.

Level of evidence: Level IV, Prognostic Study.

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来源期刊
CiteScore
2.00
自引率
0.00%
发文量
66
审稿时长
>12 weeks
期刊介绍: Acta Orthopaedica et Traumatologica Turcica (AOTT) is an international, scientific, open access periodical published in accordance with independent, unbiased, and double-blinded peer-review principles. The journal is the official publication of the Turkish Association of Orthopaedics and Traumatology, and Turkish Society of Orthopaedics and Traumatology. It is published bimonthly in January, March, May, July, September, and November. The publication language of the journal is English. The aim of the journal is to publish original studies of the highest scientific and clinical value in orthopedics, traumatology, and related disciplines. The scope of the journal includes but not limited to diagnostic, treatment, and prevention methods related to orthopedics and traumatology. Acta Orthopaedica et Traumatologica Turcica publishes clinical and basic research articles, case reports, personal clinical and technical notes, systematic reviews and meta-analyses and letters to the Editor. Proceedings of scientific meetings are also considered for publication. The target audience of the journal includes healthcare professionals, physicians, and researchers who are interested or working in orthopedics and traumatology field, and related disciplines.
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