脊柱手术中俯卧位压迫性损伤的发生率及危险因素:一项回顾性队列研究。

IF 2 4区 医学 Q2 NURSING
Thanyawit Ninlaphut, Nittaya Boonsri, Nichawan Koompong
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引用次数: 0

摘要

目的:本研究旨在探讨脊柱手术中俯卧位压迫性损伤的发生率及相关危险因素。设计:回顾性队列研究。方法:对590例采用俯卧位脊柱手术的患者进行潜在危险因素相关pi的比较。术前患者特征、术中因素和术后结果收集基于现有文献的患者病历表。进行单因素和多因素logistic回归分析,以确定pi发生的独立危险因素。结果:PIs总发生率为26.94%。最常见的受累部位为面部、胸部和髂前上棘(分别为89.94%、89.30%和77.35%)。大多数患者出现1期(89.30%)和2期(11.70%)pi。多因素分析显示,贫血(校正优势比[AOR] = 2.13, 95%可信区间[CI] = 1.09 ~ 4.16, P = 0.026)、肥胖(AOR = 2.29, 95% CI = 1.26 ~ 4.97, P = 0.004)、手术时间超过6小时(AOR = 4.49, 95% CI = 2.31 ~ 8.74, P < 0.001)、出血量大于750 mL (AOR = 6.45, 95% CI = 2.42 ~ 25.95, P < 0.001)是发生PI的重要危险因素。在亚组分析中,以手术时间为标准评价发生pi的风险。贫血显著增加手术时间超过6小时发生PIs的风险(AOR = 2.75, 95% CI = 1.34 ~ 4.79, P = 0.004)。肥胖是较短手术(AOR = 2.59, 95% CI = 2.06 ~ 5.97, P = 0.004)和较长手术(AOR = 4.50, 95% CI = 2.75 ~ 8.44, P = 0.001)的重要危险因素。出血量大于750 mL是短时间手术(AOR = 4.42, 95% CI = 2.42 ~ 19.95, P < 0.001)和长时间手术(AOR = 8.24, 95% CI = 2.98 ~ 45.86, P < 0.001)发生PI的重要危险因素。结论:医疗保健专业人员在手术前优化患者健康方面发挥着至关重要的作用,特别是贫血、肥胖、大量失血和手术时间延长的患者。在脊柱手术中,应实施术中管理策略,以防止俯卧位时发生pi。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Incidence and Risk Factors of Pressure Injury in Patients Undergoing Spinal Surgery in the Prone Position: A Retrospective Cohort Study.

Purpose: This study was performed to investigate the incidence rate and risk factors associated with pressure injuries (PIs) in patients undergoing spinal surgery in the prone position.

Design: A retrospective cohort study.

Methods: A total of 590 patients who underwent spinal surgery in the prone position were compared for potential risk factors-related PIs. The preoperative patient characteristics, intraoperative factors, and postoperative outcomes were collected using a patient record form based on existing literature. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for the occurrence of PIs.

Findings: The overall incidence rate of PIs was 26.94%. The most commonly affected areas were the face, chest, and anterior superior iliac spine (89.94%, 89.30%, and 77.35%, respectively). Most patients developed stage 1 (89.30%) and stage 2 (11.70%) PIs. Multivariate analysis revealed that anemia (adjusted odds ratio [AOR] = 2.13, 95% confidence interval [CI] = 1.09 to 4.16, P = .026), obesity (AOR = 2.29, 95% CI = 1.26 to 4.97, P = .004), operation time exceeding 6 hours (AOR = 4.49, 95% CI = 2.31 to 8.74, P < .001), and blood loss greater than 750 mL (AOR = 6.45, 95% CI = 2.42 to 25.95, P < .001) were significant risk factors for PI occurrence. In the subgroup analysis, the risk of PIs was evaluated based on the operation time. Anemia significantly increased the risk of PIs in surgeries lasting more than 6 hours (AOR = 2.75, 95% CI = 1.34 to 4.79, P = .004). Obesity was a significant risk factor for both shorter surgeries (AOR = 2.59, 95% CI = 2.06 to 5.97, P = .004) and longer surgeries (AOR = 4.50, 95% CI = 2.75 to 8.44, P = .001). Blood loss greater than 750 mL was a significant risk factor for PI occurrence in both shorter surgeries (AOR = 4.42, 95% CI = 2.42 to 19.95, P < .001) and longer surgeries (AOR = 8.24, 95% CI = 2.98 to 45.86, P < .001).

Conclusions: Health care professionals play a crucial role in optimizing patient health before surgery, particularly patients with anemia, obesity, significant blood loss, and prolonged operation times. Intraoperative management strategies should be implemented to prevent PIs during spinal surgeries in the prone position.

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来源期刊
CiteScore
2.20
自引率
17.60%
发文量
279
审稿时长
90 days
期刊介绍: The Journal of PeriAnesthesia Nursing provides original, peer-reviewed research for a primary audience that includes nurses in perianesthesia settings, including ambulatory surgery, preadmission testing, postanesthesia care (Phases I and II), extended observation, and pain management. The Journal provides a forum for sharing professional knowledge and experience relating to management, ethics, legislation, research, and other aspects of perianesthesia nursing.
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