老年患者围手术期发病率和死亡率。回顾性研究3905例]。

P M Lauven, H Stoeckel, B J Ebeling
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摘要

回顾性研究3905例60岁以上接受外科、泌尿外科、骨科或眼科干预的患者的术前状况、术中特点和术后并发症。只有3.2%的老年患者(75岁以上),但7.2%的老年患者(60 - 74岁)没有并存疾病。既往病史为心肌(54.5%)、呼吸系统疾病(41.3%)、高血压(32.6%)、心律失常(30.8%)和糖尿病(17.6%)。在老年患者中,58.1%的患者ASA身体状态为III ~ V级,而在老年患者中仅为43.2%。在麻醉和恢复期间的特点是(总的):心律失常(8.3%),血压下降(5.9%)和升高(1.6%)在老年人中明显多于老年患者,而出血(4.5%)在老年人中与老年人没有区别。与年龄无关,11.6%的患者术后在重症监护病房接受监测。47.3%的患者未发生任何术后并发症。老年患者术后心脏、呼吸、中枢神经及致死性并发症的发生率均不显著高于老年患者。然而,随着ASA身体状况的增加,并发症的发生率明显增加。老年人和老年患者在急诊干预后的死亡率分别为17.8%和24.7%,约为择期手术后的10倍(两组均为2%)。
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[Perioperative morbidity and mortality of geriatric patients. A retrospective study of 3905 cases].

3905 patients of more than 60 years of age who underwent surgical, urological, orthopaedic or opthalmologic interventions, were retrospectively investigated with respect to preoperative condition, intraoperative peculiarities and postoperative complications. Only 3.2% of the old patients (of more than 75 years of age), but 7.2% of elderly patients (between 60 and 74 years of age) had no coexisting disease. Preexisting diseases were myocardial (54.5%) and respiratory diseases (41.3%), hypertension (32.6%), dysrhythmia (30.8%) and diabetes mellitus (17.6%). From the old patients, 58.1% were classified into ASA physical status III to V but only 43.2% from the elderly patients. Peculiarities during anaesthesia and recovery period were (in total): dysrhythmia (8.3%), blood pressure decrease (5.9%) and increase (1.6%) that were significantly more often seen in old than in elderly patients whereas bleeding (4.5%) in the old was not different from the elderly. Independent of age, 11.6% of patients were monitored postoperatively on an intensive-care unit. 47.3% of all patients did not develop any postoperative complication. The incidence of postoperative cardiac, respiratory, central nervous, and lethal complications was not significantly higher in old than in elderly patients. However, the incidence of complications increased significantly with ASA physical status. Mortality of elderly and old patients after emergency interventions was 17.8% and 24.7% respectively and about 10 times that high as after elective surgery (2% in both groups.)

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