頁籤選單縮合
題 名 | Predictors of Postoperative Mortality in Patients with Fournier's Gangrene=弗尼爾氏壞疽患者術後死亡率的預後因子 |
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作 者 | 林耿億; 張奇男; 陳威佑; 陳志誠; 黃玄遠; 陳宏彰; 黃灯明; 林屏沂; 陳堯俐; 王愷晟; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷 期 | 25:2 2014.06[民103.06] |
頁 次 | 頁36-42 |
分類號 | 416.245 |
關鍵詞 | 弗尼爾氏壞疽; 弗尼爾氏壞疽嚴重指數; Fournier's gangrene; Fournier's gangrene severity index score; |
語 文 | 英文(English) |
中文摘要 | 目的 確認弗尼爾氏壞疽患者術後死亡率的危險因子。方法 這是一篇回溯性的統計研究,自2006年1月到2012年12月期間,共36位診斷為弗尼爾氏壞疽的患者。我們使用單變數與多變數邏輯迴歸分析計算出勝算比。結果 36位弗尼爾氏壞疽患者中,有32位男性(89%)及4位女性(11%)。平均年齡為59.97 ± 15.3歲(範圍:24-91歲)。整體死亡率為30.5%。最常見的病史為糖尿病(52.8%)與高血壓(50%)。弗尼爾氏壞疽嚴重指數平均落在6.5分。所有患者平均清創2.17次。44.4%患者接收分流性大腸造口。根據單變數分析,與術後死亡率有關的預後因子為年齡、腎功能、加護病房住院天數、呼吸速率、血鉀、血清肌酸酐、血容比與弗尼爾氏壞疽嚴重指數。再進一步作多變數分析,弗尼爾氏壞疽嚴重指數是其中唯一獨立的預後因子。結論 入院時的弗尼爾氏壞疽嚴重指數是唯一獨立的預後因子,可以量化弗尼爾氏壞疽的嚴重度與預後,藉此早期辨識高危險患者並積極治療,以達到降低死亡率的目標。 |
英文摘要 | Purpose. To identify the clinical risk factors associated with postoperative mortality in patients with Fournier's gangrene. Methods. We retrospectively enrolled 36 patients who were treated for Fournier's gangrene during the period January 2006 to December 2012 at the Changhua Christian Hospital. Univariate and multivariate analyses were used to investigate possible risk factors for post-operative mortality in patients with Fournier's gangrene, including renal dysfunction, intensive care unit admission, age, respiratory rate, potassium, creatinine, medical history (diabetes mellitus, DM; hypertension, renal failure, and liver cirrhosis), origin of infection, history of malignancy, the presence of stoma, the number of operations, vital signs, the level of electrolytes, hematocrit, and Fournier's gangrene severity index. Results. Mean age was 59.97 ± 15.3 years (range, 24-91 years) and most of the patients were men (32 of 36, 89%). The overall mortality rate was 30.5% (11 of 32). The most common predisposing illnesses were diabetes mellitus (52.8%) and hypertension (50%). The average Fournier's gangrene severity index (FGSI) score on admission was 6.5. All patients required radical surgical debridement and the majority (n = 25, 69%) required more than one session (mean, 2.8; range 2-4). Diverting colostomy was performed in 44.4% of patients. Although the univariate analysis showed that age, sex, renal dysfunction, intensive care unit admission, and most of the individual variables that make up the FGSI score were significant predictors of postoperative death, the mulitivariate analysis revealed that only the index score itself was an in independent predictor of postoperative mortality. Conclusion. The Fournier's gangrene severity index score at admission is predictive of postoperative outcome. |
本系統中英文摘要資訊取自各篇刊載內容。