老年胃肠道肿瘤患者术后恢复质量变化轨迹及影响因素分析OA
Analysis of the trajectories and influencing factors of changes in the quality of postoperative recovery in elderly patients with gastrointestinal tumors
目的 分析老年胃肠道肿瘤患者术后恢复质量变化轨迹及其影响因素.方法 选取老年胃肠道肿瘤患者为研究对象.收集患者的临床资料.采用15项恢复质量量表调查患者术前、术后7 d和术后1、3、6个月的恢复质量情况.采用潜类别增长模型识别术后恢复质量变化轨迹的潜在类别.采用无序多分类Logistic回归分析筛选老年胃肠道肿瘤患者术后恢复质量变化轨迹的影响因素.结果 共230例患者完成本研究.老年胃肠道肿瘤患者术后恢复质量变化轨迹呈现3个潜在类别,即高恢复质量快速上升(37.39％)、中恢复质量缓慢上升(46.52％)、低恢复质量上升波动(16.09％).无序多分类Logistic回归分析显示,出血量≥100 mL、低蛋白血症、低血红蛋白、术后衰弱得分高、低健康素养水平、术后住院时间长、住院期间发生术后并发症,是老年胃肠道肿瘤患者"高恢复质量快速上升"转为"中恢复质量缓慢上升"的独立影响因素(P＜0.05);低蛋白血症、术后衰弱得分高、术后住院时间长、住院期间发生术后并发症、术后6个月内因胃肠道疾病入院,是老年胃肠道肿瘤患者"高恢复质量快速上升"转为"低恢复质量上升波动"的独立影响因素(P＜0.05).结论 老年胃肠道肿瘤患者术后恢复质量呈现3种发展轨迹,且其恢复质量初始水平及变化速度存在显著群体异质性.
Objective To analyze the trajectories and influencing factors of changes in the quality of postoperative recovery in elderly patients with gastrointestinal tumors.Methods Elderly patients with gastrointestinal tumors were selected as the study subjects,and their clinical data were collected.The 15-item Quality of Recovery scale was used to investigate the quality of recovery before surgeiy,and at 7 days,1 month,3 months and 6 months after surgeiy.Latent class growth modeling was employed to identify latent classes of trajectories of changes in the quality of postoperative recovery.Unordered multinomial logistic regression was used to screen the influencing factors of the trajectories of changes in the quality of postoperative recovery in elderly patients with gastrointestinal tumors.Results A total of 230 patients completed this study.The trajectories of changes in the quality of postoperative re-covery in elderly patients with gastrointestinal tumors exhibited three latent classes,namely rapid in-crease with high recovery quality(37.39％),slow increase with moderate recovery quality(46.52％),and fluctuating increase with low recovery quality(16.09％).Unordered multinomial lo-gistic regression analysis revealed that blood loss ≥100 mL,hypoproteinemia,low hemoglobin levels,high postoperative frailty scores,low health literacy levels,prolonged postoperative hospital stays,and the occurrence of postoperative complications during hospitalization were independent influencing factors for the transition from"rapid increase with high recovery quality"to"slow increase with moderate recovery quality"in elderly patients with gastrointestinal tumors(P＜0.05);hypopro-teinemia,high postoperative frailty scores,prolonged postoperative hospital stays,the occurrence of postoperative complications during hospitalization,and readmission for gastrointestinal diseases with-in 6 months after surgery were independent influencing factors for the transition from"rapid increase with high recovery quality"to"fluctuating increase with low recovery quality"in elderly patients with gastrointestinal tumors(P＜0.05).Conclusion The quality of postoperative recovery in eld-erly patients with gastrointestinal tumors demonstrates three developmental trajectories,with signifi-cant population heterogeneity in the initial level and rate of change in recovery quality.
李佳佳;石芳;王秀芝;王梅
安徽医科大学第一附属医院急诊外科,安徽 合肥,230022安徽医科大学第一附属医院急诊外科,安徽 合肥,230022安徽医科大学第一附属医院肾脏内科,安徽 合肥,230022安徽医科大学第一附属医院急诊外科,安徽 合肥,230022
医药卫生
老年人胃肠道肿瘤术后恢复质量变化轨迹影响因素潜类别增长模型纵向研究群体异质性
the elderlygastrointestinal tumorsquality of postoperative recoverytrajectories of changeinfluencing factorslatent class growth modelinglongitudinal studypopulation hetero-geneity
《实用临床医药杂志》 2026 (5)
88-94,102,8
安徽省医疗卫生重点专科建设项目(皖卫函[2021]273号)
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