南方医科大学学报2025，Vol.45Issue(4)：736-743,8.DOI:10.12122/j.issn.1673-4254.2025.04.08
老年患者胃肠道手术后综合并发症的危险因素——一项多中心观察性研究
Risk factors for overall postoperative complications in elderly patients undergoing gastrointestinal surgeries:a multicenter observational study
摘要
Abstract
Objective To investigate the risk factors of overall postoperative complications in elderly patients undergoing gastrointestinal surgeries.Methods This study was conducted among a total of 1388 elderly patients,who underwent elective gastrointestinal surgeries at 17 centers across China between April,2020 and April,2022.The primary outcome was the incidence of postoperative complications within 30 days,including procedure-related,neuropsychiatric,respiratory,cardiovascular,and gastrointestinal complications as well as acute kidney injury.Baseline characteristics,preoperative psychological and functional status,intraoperative anesthesia and surgical factors,intraoperative medication,use of nerve block,and postoperative analgesia methods were compared between the patients experiencing one or more postoperative complications and those without complications.Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors for postoperative complications.The relationship between postoperative acute pain and each type of complication were explored.Results The incidence of overall postoperative complications was 50.8%(705/1388)in these patients.Multivariate analysis showed that age(OR:1.026;95%CI:1.006-1.046),prognostic nutritional index(OR:0.998;95%CI:0.997-1.000),preoperative EuroQol-5 dimensions score(OR:0.094;95%CI:0.018-0.500),blood loss(OR:1.002;95%CI:1.001-1.003),and acute postoperative pain(OR:1.308;95%CI:1.033-1.657)were significantly associated with the occurrence of postoperative complications.Specifically,patients experiencing severe postoperative pain had a significantly higher incidence of neuropsychiatric(27.2%vs 19.8%),procedure-related(17.3%vs 10.2%),and cardiovascular complications(3.6%vs 1.7%).Conclusions An advanced age,a low preoperative nutritional index,a poor quality of life score,a greater volume of intraoperative blood loss,and acute postoperative pain are independent risk factors for postoperative complications in elderly patients undergoing gastrointestinal surgeries.There is a significant association between acute postoperative pain and multi-system complications.关键词
胃肠道手术/老年患者/危险因素/术后并发症/疼痛Key words
gastrointestinal surgery/elderly patients/risk factors/postoperative complications/pain引用本文复制引用
吕雪彩,张宏,米卫东,刘艳红,韩诗怡,张浩赟,侯爱生,周志康,史立凯,高洁,曹江北..老年患者胃肠道手术后综合并发症的危险因素——一项多中心观察性研究[J].南方医科大学学报,2025,45(4):736-743,8.基金项目
国家重点研发计划(2018YFC2001900) Supported by the National Key Research and Development Program of China(2018YFC2001900). （2018YFC2001900）
