摘要
目的探讨衰弱指数(FI)与腰椎术后并发症的关系。方法检索PubMed、Cochrane Library、Web of Science、EMbase、CINAHL、中国知网、维普数据库、万方医学数据库、中国生物医学文献数据库中关于FI与腰椎术后并发症相关的文献,检索时限为建库至2025年1月1日。由两名研究人员独立进行文献筛选、质量评价以及数据提取,采用Stata 18.0软件进行荟萃分析。结果本文共纳入14项研究。荟萃分析结果显示,衰弱患者腰椎术后有较高风险发生任意并发症(OR=1.67,95%CI:1.38~2.01,P<0.001)、死亡(OR=9.33,95%CI:1.41~61.71,P<0.001)、肺部并发症(OR=3.09,95%CI:2.36~4.05,P=0.341)、泌尿系统并发症(OR=1.74,95%CI:1.08~2.83,P=0.044)、心脏并发症(OR=2.99,95%CI:2.36~3.80,P=0.941)、脑血管疾病(OR=2.94,95%CI:2.12~4.07,P=0.983)、败血症(OR=1.92,95%CI:1.61~2.29,P=0.473)、手术部位感染(OR=1.51,95%CI:1.29~1.76,P=0.741)、术后输血(OR=1.36,95%CI:1.17~1.59,P=0.289)、再次入院(OR=1.59,95%CI:1.23~2.06,P=0.284)以及再次手术(OR=1.36,95%CI:1.07~1.73,P=0.294),但术前衰弱与术后胃肠道并发症(OR=0.86,95%CI:0.55~1.37,P=0.396)、谵妄(OR=1.33,95%CI:0.93~1.91,P=0.480)、深静脉血栓(OR=1.10,95%CI:0.89~1.36,P=0.915)的发生统计学上无显著关联。结论衰弱患者腰椎术后发生并发症的风险明显高于非衰弱患者,医护人员应重视对接受腰椎手术的患者进行衰弱筛查并尽早干预,以改善患者的预后。
Objective To systematically evaluate the relationship between frailty index(FI)and postoperative complications after lumbar spinal surgery.Methods This article retrieved relevant studies about the relationship between FI and postoperative complications after lumbar spinal surgery from PubMed,Cochrane Library,Web of Science,EMbase,CINAHL,CNKI,VIP database,Wanfang Medical Database and China Biomedical Literature Database.The retrieval time limit was from the establishment of the database to January 1,2025.Two researchers independently conducted literature screening,quality evaluation,and data extraction.Stata 18.0 software was used for meta-analysis.Results A total of 14 articles were included.Meta-analysis results showed that frail patients had a higher risk of any postoperative complications after lumbar spinal surgery(OR=1.67,95%CI:1.38~2.01,P<0.001),death(OR=9.33,95%CI:1.41~61.71,P<0.001),pulmonary complications(OR=3.09,95%CI:2.36~4.05,P=0.341),urinary complications(OR=1.74,95%CI:1.08~2.83,P=0.044),cardiac complications(OR=2.99,95%CI:2.36~3.80,P=0.941),cardiovascular disease(OR=2.94,95%CI:2.12~4.07,P=0.983),sepsis(OR=1.92,95%CI:1.61~2.29,P=0.473),surgical site infections(OR=1.51,95%CI:1.29~1.76,P=0.741),postoperative transfusion(OR=1.36,95%CI:1.17~1.59,P=0.289),readmission(OR=1.59,95%CI:1.23~2.06,P=0.284)and reoperation(OR=1.36,95%CI:1.07~1.73,P=0.294),but there was no statistically significant association between preoperative frailty and postoperative gastrointestinal complications(OR=0.86,95%CI:0.55~1.37,P=0.396),delirium(OR=1.33,95%CI:0.93~1.91,P=0.480)and deep vein thrombosis(OR=1.10,95%CI:0.89~1.36,P=0.915).Conclusion Frail patients have a significantly higher risk of postoperative complications after lumbar surgery compared to non-frail patients.Medical and nursing staff should pay attention to the screening of patients'frailty and intervene as soon as possible to improve the prognosis of patients.
作者
韩冰
毕宇彤
何达
Han Bing;Bi Yutong;He Da(Department of Nursing,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China;School of Nursing,Capital Medical University,Beijing 100069,China;Department of Spinal Surgery,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China)
出处
《中华损伤与修复杂志(电子版)》
2025年第3期233-240,共8页
Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)
基金
北京市属医院科研培育项目(PX2022017)。
关键词
腰椎
手术后并发症
衰弱指数
荟萃分析
Lumbar vertebrae
Postoperative complications
Frailty index
Meta-analysis
