Analysis of influencing factors of postoperative exhaust time in patients with spinal tuberculosis

doi:10.19982/j.issn.1000-6621.20220150

Abstract

Abstract:

Objective: To explore the influencing factors of postoperative exhaust time in patients with spinal tuberculosis. Methods: A prospective cross-sectional study was conducted in 75 newly admitted patients with spinal tuberculosis from the Orthopedics Department of Beijing Chest Hospital, Capital Medical University between February and December 2021. All the patients met the inclusion criteria. The basic information of patients, routine blood test and blood biochemistry on the next day after admission and the next day after surgery, the procedure and duration of surgery, the management of pain, postoperative thirst scores, intraoperative bleeding and blood transfusion, etc., as well as whether or not participate in nutritional management were collected by the case report form. Univariate correlation analysis and multiple stepwise regression analysis were performed to explore the potential influencing factors of exhaust time of patients with spinal tuberculosis. Results: The postoperative exhaust time of 75 patients with spinal tuberculosis ranged from 0.5 to 98.0 hours, and the median time was 27.0 (19.0, 40.0) hours. There were only 29 patients with exhaust time of ≤24 hours (38.7%). The results of univariate correlation analysis showed that the postoperative exhaust time in patients with spinal tuberculosis was negatively correlated with the concentration of hemoglobin at admission ((124.1±17.2)g/L) (r=-0.289, P=0.012) and positively correlated with the thirst score 2 hours after surgery (5.0 (4.0, 6.0)) (r=0.258, P=0.025), but not significantly correlated with other factors. For example, the postoperative exhaust time in patients was not significantly correlated with nutrition management (26.0 (16.0,38.0) h and 30.8 (21.3, 45.3) h) (Z=-1.915,P=0.056) or pain score 24 hours after surgery (4.0 (3.0, 6.0) score)(r=0.171, P=0.143). The results of the multiple stepwise regression showed that the concentration of hemoglobin at admission (β=-0.349, P=0.002), pain score 24 hours after surgery (β=3.143, P=0.003), and nutritional management (β=-10.312, P=0.008) were the influencing factors for exhaust time in these patients, the postoperative exhaust time might shorten with the increasement of the concentration of hemoglobin and the improvement of nutrition management, and might prolong with the increase of pain score 24 hours after surgery. Conclusion: The postoperative exhaust recovery time of patients with spinal tuberculosis is long. Clinical medical staffs should pay more attention to the patients with anemia at admission, those who lack of whole-process nutrition management during hospitalization, and high pain score 24 hours after surgery.

Key words: Tuberculosis,spinal, Postoperative exhaust time, Factor analysis,statistical

CLC Number:

R529.2

ZHANG Ya-chao, LI Zhuo, CHEN Yang, MA Jiao-jie, LEI Guo-hua. Analysis of influencing factors of postoperative exhaust time in patients with spinal tuberculosis[J]. Chinese Journal of Antituberculosis, 2022, 44(6): 570-575. doi: 10.19982/j.issn.1000-6621.20220150

Figures/Tables 3

临床指标	数值	r值	P值
入院次日血红蛋白水平(g/L, $x ¯$ ±s)	124.1±17.2	-0.289	0.012
术后次日血红蛋白水平(g/L, $x ¯$ ±s)	104.6±15.1	-0.208	0.073
入院次日白细胞计数(×10⁹/L, $x ¯$ ±s)	6.1±2.1	0.003	0.979
术后次日白细胞计数(×10⁹/L, $x ¯$ ±s)	10.9±3.0	0.052	0.658
入院次日白蛋白水平(g/L, $x ¯$ ±s)	39.4±4.0	-0.139	0.235
术后次日白蛋白水平(g/L, $x ¯$ ±s)	32.5±3.7	-0.185	0.115
入院次日血糖水平(mmol/L, $x ¯$ ±s)	4.9±0.7	0.078	0.509
术后次日血糖水平(mmol/L, $x ¯$ ±s)	6.0±1.2	0.171	0.145
手术时长(min, $x ¯$ ±s)	204.6±60.0	-0.038	0.745
术中出血量[ml,M(Q₁,Q₃)]	400.0(200.0,500.0)	0.017	0.884
术后2h口渴评分[分,M(Q₁,Q₃)]	5.0(4.0,6.0)	0.258	0.025
术后6h口渴评分[分,M(Q₁,Q₃)]	5.0(4.0,7.0)	0.135	0.248
术后次日清晨口渴评分[分,M(Q₁,Q₃)]	4.0(3.0,6.0)	0.187	0.109
术后24h疼痛评分[分,M(Q₁,Q₃)]	4.0(3.0,6.0)	0.171	0.143
NRS 2002评分≥3分[例(发生率,%)]	35(46.7)	0.166	0.156
实施融合术[例(发生率,%)]	70(93.3)	0.130	0.267
强镇痛处理[例(发生率,%)]	17(22.7)	-0.086	0.462

指标	β值	s $x ¯$ 值	标准化β值	t值	P值
常量	65.605	14.297	-	4.589	0.000
入院次日血红蛋白水平	-0.349	0.110	-0.333	-3.158	0.002
入院次日白细胞计数	0.138	1.291	0.201	0.153	0.928
入院次日白蛋白水平	0.066	0.580	0.564	0.069	0.851
入院次日血糖水平	0.104	1.000	0.321	0.119	0.990
术后2h口渴评分	0.181	1.711	0.092	0.200	0.939
术后24h疼痛评分	3.143	1.007	0.328	3.119	0.003
手术时长	0.142	1.317	0.192	0.156	0.921
术中出血量	0.073	0.663	0.510	0.079	0.897
NRS 2002评分(入院)	-0.060	-0.451	0.654	-0.054	0.624
手术方式	0.128	1.224	0.225	0.145	0.983
疼痛处理	-0.107	-1.002	0.320	-0.119	0.935
有营养管理	-10.312	3.768	-0.288	-2.736	0.008

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指标	例数(构成比,%)	术后恢复排气时间[h,M(Q₁,Q₃)]	Z值	P值
性别			-1.252	0.211
男性	39(52.0)	26.0(17.0,38.0)
女性	36(48.0)	32.5(19.3,45.0)
年龄组(岁)			-0.149	0.882
0~44	34(45.3)	26.5(17.8,41.5)
≥45	41(54.7)	27.0(19.5,40.5)
合并肺结核			-0.767	0.443
否	47(62.7)	27.0(17.0,38.0)
是	28(37.3)	27.0(21.0,46.5)
合并其他疾病			-0.931	0.352
无	47(62.7)	27.0(17.0,38.0)
有	28(37.3)	28.5(21.3,45.0)
营养管理			-1.915	0.056
无	36(48.0)	30.8(21.3,45.3)
有	39(52.0)	26.0(16.0,38.0)
术中输血			-0.533	0.594
无	55(73.3)	27.0(18.0,40.0)
有	20(26.7)	29.0(20.1,46.5)