目的评估改良衰弱指数(Modified frailty index,mFI)和美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级对老年腹腔镜手术患者麻醉相关不良事件的预测价值。方法收集皖南医学院第一附属医院2019年12月至2023年10月行...目的评估改良衰弱指数(Modified frailty index,mFI)和美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级对老年腹腔镜手术患者麻醉相关不良事件的预测价值。方法收集皖南医学院第一附属医院2019年12月至2023年10月行老年腹腔镜手术的102例患者,根据患者术后是否发生麻醉相关不良事件分为发生组(n=23)、未发生组(n=79),比较两组临床资料、mFI、ASA分级,Spearman相关性分析mFI与ASA分级关系,采用受试者工作特征(Receiver operating characteristic,ROC)曲线分析mFI、ASA分级对麻醉相关不良事件的预测价值。结果与未发生组比较,发生组年龄、体质指数(Body mass index,BMI)、合并糖尿病、慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)比例升高,mFI和ASA分级升高,差异有统计学意义(P<0.05)。mFI与ASA分级呈正相关(r=0.627,P<0.001);衰弱患者发生麻醉相关不良事件的风险是非衰弱患者的4.580倍,ASA分级Ⅲ级患者发生麻醉相关不良事件的风险是Ⅰ~Ⅱ级患者的5.152倍(P<0.05);mFI、ASA分级联合预测麻醉相关不良事件的预测价值优于mFI、ASA分级单独预测(P<0.05)。结论mFI、ASA分级联合能有效预测老年腹腔镜手术患者麻醉相关不良事件发生情况,为临床预测麻醉相关不良事件提供理论依据。展开更多
Projections of climate change are essential to guide sustainable development plans in the tropical Andean countries such as Peru. This study assessed the projections of precipitation and potential evaporation, rain er...Projections of climate change are essential to guide sustainable development plans in the tropical Andean countries such as Peru. This study assessed the projections of precipitation and potential evaporation, rain erosive potential, and precipitation concentration in the Mantaro River Basin, in the Peruvian Andes, which is important for agriculture and energy production in Peru. We assumed the Intergovernmental Panel on Climate Change(IPCC)A_1B greenhouse gas emission scenario and simulated the global climate change by the HadCM_3 global climate model. Due to the steepness of the mountain slopes and the narrowness of the river valley, this study uses the downscaling of the global model simulations by the regional Eta model down to 20-km resolution. The downscaling projections show decrease in the monthly precipitation with respect to the baseline period, especially during the rainy season,between February and April, until the end of the 21st century. Meanwhile, a progressive increase in the monthly evaporation from the baseline period is projected. The Modified Fournier Index(MFI) shows a statistically significant downward trend in the Mantaro River Basin, which suggests a possible reduction in the rain erosive potential. The Precipitation Concentration Index(PCI) shows a statistically significant increasing trend, which indicates increasingly more irregular temporal distribution of precipitation towards the end of the century. The results of this study allow us to conclude that there should be a gradual increase in water deficit and precipitation concentration. Both changes can be negative for agriculture, power generation, and water supply in the Mantaro River Basin in Peru.展开更多
文摘目的评估改良衰弱指数(Modified frailty index,mFI)和美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级对老年腹腔镜手术患者麻醉相关不良事件的预测价值。方法收集皖南医学院第一附属医院2019年12月至2023年10月行老年腹腔镜手术的102例患者,根据患者术后是否发生麻醉相关不良事件分为发生组(n=23)、未发生组(n=79),比较两组临床资料、mFI、ASA分级,Spearman相关性分析mFI与ASA分级关系,采用受试者工作特征(Receiver operating characteristic,ROC)曲线分析mFI、ASA分级对麻醉相关不良事件的预测价值。结果与未发生组比较,发生组年龄、体质指数(Body mass index,BMI)、合并糖尿病、慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)比例升高,mFI和ASA分级升高,差异有统计学意义(P<0.05)。mFI与ASA分级呈正相关(r=0.627,P<0.001);衰弱患者发生麻醉相关不良事件的风险是非衰弱患者的4.580倍,ASA分级Ⅲ级患者发生麻醉相关不良事件的风险是Ⅰ~Ⅱ级患者的5.152倍(P<0.05);mFI、ASA分级联合预测麻醉相关不良事件的预测价值优于mFI、ASA分级单独预测(P<0.05)。结论mFI、ASA分级联合能有效预测老年腹腔镜手术患者麻醉相关不良事件发生情况,为临床预测麻醉相关不良事件提供理论依据。
基金FAPEMIG (PPM X 45-16)CNPqpartially funded by CNPq 308035/2013-5
文摘Projections of climate change are essential to guide sustainable development plans in the tropical Andean countries such as Peru. This study assessed the projections of precipitation and potential evaporation, rain erosive potential, and precipitation concentration in the Mantaro River Basin, in the Peruvian Andes, which is important for agriculture and energy production in Peru. We assumed the Intergovernmental Panel on Climate Change(IPCC)A_1B greenhouse gas emission scenario and simulated the global climate change by the HadCM_3 global climate model. Due to the steepness of the mountain slopes and the narrowness of the river valley, this study uses the downscaling of the global model simulations by the regional Eta model down to 20-km resolution. The downscaling projections show decrease in the monthly precipitation with respect to the baseline period, especially during the rainy season,between February and April, until the end of the 21st century. Meanwhile, a progressive increase in the monthly evaporation from the baseline period is projected. The Modified Fournier Index(MFI) shows a statistically significant downward trend in the Mantaro River Basin, which suggests a possible reduction in the rain erosive potential. The Precipitation Concentration Index(PCI) shows a statistically significant increasing trend, which indicates increasingly more irregular temporal distribution of precipitation towards the end of the century. The results of this study allow us to conclude that there should be a gradual increase in water deficit and precipitation concentration. Both changes can be negative for agriculture, power generation, and water supply in the Mantaro River Basin in Peru.
