老年人颈部剥离术后缺血性中风。

Chuan-Yi Kuo, Yi-Ting Chen, Cheuk-Kwan Sun, Kuo-Chuan Hung
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引用次数: 0

摘要

目的:尽管已知围术期中风与围术期死亡率有关,但老年患者颈部解剖后中风的发生率仍不清楚。本研究比较了老年患者和年轻患者颈部解剖相关围手术期中风的发生率:在一个中心对 2012 年 6 月至 2016 年 7 月间接受颈部切除术治疗头颈部癌症的 1057 例患者进行了回顾性研究。患者分为老年组(年龄≥65 岁,n = 177)和年轻组(年龄 n = 880)(平均年龄分别为 72.3 ± 6.1 和 53.3 ± 7.6)。比较了患者、人体测量和临床特征,包括诊断、合并症、住院时间和围手术期中风的发生率:结果:年轻患者更有可能是男性(P = 0.001)和接受过放疗(P = 0.013)。老年患者易患因素的发生率更高,包括脑血管意外史(P = 0.002)、高血压(P < 0.001)、糖尿病(P < 0.001)和冠状动脉疾病(P < 0.001)。老年患者的住院时间也更长(P < 0.001),曾接受过放疗被认为是一个风险因素(调整后的几率比 = 3.79,P = 0.0078)。两名老年患者(1.1%)被诊断为术后缺血性中风,而年轻组患者中没有缺血性中风发生(P = 0.028)。围手术期中风的总发生率为 0.19%:结论:老年人围手术期中风的发生率高于年轻人。结论:老年患者围手术期中风的发生率高于年轻组。此外,老年患者中与颈部解剖相关的缺血性中风的发生率高于之前报道的普通头颈部手术后老年人群的发生率,这表明接受大范围颈部手术的老年患者中风的风险增加。
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Ischemic stroke following neck dissection in the elderly.

Objective: Despite the known association of perioperative stroke with perioperative mortality, the prevalence of stroke following neck dissection in elderly patients remains unclear. This study compared the incidence of neck dissection-associated perioperative stroke in elderly and younger patients.

Materials and methods: Totally, 1057 patients receiving neck dissection for head and neck cancers between June 2012 and July 2016 were reviewed at a single center. The patients were divided into elderly (age ≥65 years, n = 177) and younger (age <65 years, n = 880) groups (mean age: 72.3 ± 6.1 and 53.3 ± 7.6, respectively). Patient, anthropometric, and clinical characteristics including diagnoses, comorbidities, length of hospitalization, and incidence of perioperative stroke were compared.

Results: Younger patients were more likely to be male (P = 0.001) and to have received radiotherapy (P = 0.013). The prevalence of predisposing factors was higher in the elderly, including history of cerebral vascular accident (P = 0.002), hypertension (P < 0.001), diabetes (P < 0.001), and coronary artery disease (P < 0.001). Elderly patients also had longer hospitalizations (P < 0.001) for which previous radiotherapy was identified as a risk factor (adjusted odds ratio = 3.79, P = 0.0078). Postoperative ischemic stroke was diagnosed in two elderly patients (1.1%), whereas no ischemic strokes occurred in the younger group (P = 0.028). The overall incidence of perioperative stroke was 0.19%.

Conclusion: The incidence of perioperative stroke was higher in the elderly than in the younger group. Furthermore, the prevalence of ischemic stroke in elderly patients associated with neck dissection was higher than that previously reported in the aged population after general head and neck operations, highlighting an increased risk of stroke in elderly patients receiving extensive neck surgery.

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