麻醉分级在围术期死亡风险评估中的作用——214例围术期死亡患者的回顾性分析  

The role of anesthesia grade in the risk assessment of perioperative deaths——retrospective analysis of 214 perioperative deaths

作　　者：刘羡 曹娟[2] 孙蓓[3] 宦烨 蔡宏伟[3] LIU Xian;CAO Juan;SUN Bei;HUAN Ye;CAI Hongwei(Department of Anesthesiology,Hunan Provincial People s Hospital(The First Affiliated Hospital of Hunan Normal University),Changsha 410005;Department of Anesthesiology,Henan Provincial People s Hospital,Zhengzhou 450003;Department of Anesthesiology,Xiangya Hospital of Central South University,Changsha 410008,China)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)麻醉科,湖南长沙410005 [2]河南省人民医院麻醉科,河南郑州450003 [3]中南大学湘雅医院麻醉科,湖南长沙410008

出　　处：《麻醉安全与质控》2024年第6期327-330,共4页Perioperative Safety and Quality Assurance

基　　金：广东省中医药科研项目(20191039)。

摘　　要：目的围术期死亡患者的危险因素分析和麻醉分级在围术期死亡风险评估中的作用。方法选取2007-01/2010-12期间中南大学湘雅医院所有手术患者106630例,其中有214例患者术后死亡。应用结构化问卷,收集患者基本信息和危险因素,采用Cox模型多因素分析筛选围术期死亡的危险因素。结果214例死亡病例在ASA分级中的分布,每级病例数并没有随等级的增加而增加;而在麻醉分级的分布中,随着等级的增加,各级的数量也随之增加。多因素分析显示,创伤患者的死亡风险上升59%;有心血管风险事件(CRE)患者的死亡风险上升38%;麻醉分级每上升一级,围术期死亡风险上升45%;心功能每上升一级,死亡风险上升41%。结论创伤、麻醉分级、心功能分级和CRE与围术期死亡相关。麻醉分级每上升一级,围术期死亡危险性上升45%,麻醉分级作为围术期死亡风险评估标准有良好的代表性。Objective To analyze risk factors for perioperative death and the role of anesthesia grade in the risk assessment of perioperative mortality.Methods From January 2007 to December 2010,there were a total of 106,630 cases of surgery in Xiangya Hospital of Central South University,214 of which were postoperatively fatal.Structured questionnaires were used to collect basic information of patients and risk factors,and multivariate analysis of Cox model was used to screen the risk factors of perioperative mortality.Results The distribution of 214 death cases in ASA grade showed that the number of cases per grade did not increase with the grade.In the distribution of anesthesia grade,the number of patients in each grade increased with the increase of grade levels.Multivariate analysis showed that patients with trauma had a 59%higher risk of death.Patients with cardiovascular risk events(CRE)had a 38%increased risk of death;the risk of perioperative death increased by 45%for each step higher anesthesia grade.For the deteriorated heart function,the risk of death rose 41%.Conclusion Trauma,anesthesia grade,cardiac function classification and CRE were correlated with perioperative death.For each additional elevation of anesthesia grade levels,the risk of perioperative death increased by 45%.Anesthesia grade was a good representative criterion for the risk assessment of perioperative death.

关 键 词：麻醉分级 ASA分级 术前评估 手术 

分 类 号：R614[医药卫生—麻醉学]