心臓外科手術における術前貧血に関連するリスク:多センターコホート研究
Keyvan Karkouti1, Duminda N Wijeysundera, W Scott Beattie
1Department of Anesthesia, University Health Network, University of Toronto, Toronto, Ontario, Canada, M5G 2C4. keyvan.karkouti@uhn.on.ca
Circulation
|January 4, 2008
まとめ
手術前の一般的な状態である術前貧血は,心臓外科手術患者の不良の結果のリスクを独立して増加させます. 患者の結果を改善するために,貧血の治療法を模索するためにさらなる研究が必要です.
科学分野:
- 心臓病学 心臓病学
- アネステシオロジー アネステシオロジー
- ネフロロジーはネフロロジーを用います.
背景:
- 術前貧血は,赤血球輸血の既知のリスク因子です.
- 輸血は,手術後の罹患率と死亡率の増加と関連しています.
- 心臓外科手術の結果に対する術前貧血の独立した影響は不明である.
研究 の 目的:
- 手術前貧血が心臓手術後の不良結果の独立したリスク要因であるかどうかを判断する.
- 術前貧血と病院での死亡,脳卒中,または急性腎臓損傷の複合的な結果との関連を定量化するために.
主な方法:
- 連続した心臓外科手術を受けた患者3500人を対象とした多センターコホート研究.
- 貧血の有病率 (ヘモグロビン<12.5g/dL) を評価した.
- 多変数ロジスティック回帰と傾向スコアマッチングを使用して,混同因子に調整しました.
主要な成果:
- 術前貧血の罹患率は,7つの学術病院で26%でした.
- 貧血は,有害な結果の2.0倍のリスク (調整されたオッズ比率) と独立して関連していました.
- リスク調整されたオッズ比率は1.8から2.0の範囲で,有意な関連性を示した.
結論:
- 術前貧血は,心臓外科手術における不良結果の独立した予測因子です.
- 患者の予後を改善するために,貧血の治療療法に関するさらなる調査が必要である.
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