Пациенты высокого периоперационного риска: два подхода к стратификации
№ 4 (2019) , ПЕРИОПЕРАЦИОННОЕ ВЕДЕНИЕ ПАЦИЕНТОВ
№ 4 (2019)
ПЕРИОПЕРАЦИОННОЕ ВЕДЕНИЕ ПАЦИЕНТОВ

Пациенты высокого периоперационного риска: два подхода к стратификации

https://doi.org/10.21320/1818-474X-2019-4-34-46
Опубликован 05.11.2019
Игорь Борисович Заболотских
ФГБОУ ВО «Кубанский государственный медицинский университет» МЗ РФ, Краснодар, Россия
https://orcid.org/0000-0002-3623-2546
Н.В. Трембач
ФГБОУ ВО «Кубанский государственный медицинский университет» МЗ РФ, Краснодар, Россия
https://orcid.org/0000-0002-0061-0496
#2019-4
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Ключевые слова

стратификация периоперационного риска
летальность
осложнения

Как цитировать

Заболотских И.Б., Трембач Н.В. Пациенты высокого периоперационного риска: два подхода к стратификации. Вестник интенсивной терапии имени А.И. Салтанова. 2019;(4):34–46. doi:10.21320/1818-474X-2019-4-34-46.
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Аннотация

Несмотря на успехи современной медицины, оперативные вмешательства не стали абсолютно безопасными, до сих пор частота послеоперационных осложнений и летальность остаются высокими, а послеоперационная летальность вышла на третье место среди причин смерти после ишемической болезни сердца и инсульта. Проблема оценки периоперационного риска постоянно привлекает внимание специалистов, поскольку выявление пациентов высокого риска является основой профилактики неблагоприятного исхода. Тем не менее, несмотря на всю важность, проблема эта далека от решения. Данный обзор посвящен двум подходам к стратификации риска: оценке риска летальности и риска осложнений. Анализ литературы показывает, насколько противоречивы оба этих подхода: отсутствие общепринятых определений летальности и осложнений, разнообразие критериев выделения высокого риска — все это приводит к отсутствию единого представления о высоком периоперационном риске. Существующие на данный момент системы оценки риска не лишены значительных недостатков и обладают ограниченной прогностической ценностью. Тем не менее в вопросе стандартизации исследований по стратификации риска наметился прогресс за последнее десятилетие: появляются единые определения летальности и осложнений, создаются национальные регистры — все это позволяет надеяться на улучшение качества прогноза.
https://doi.org/10.21320/1818-474X-2019-4-34-46
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