冠動脈外科手術の結果に対する年齢の影響

W S Weintraub¹, J M Craver, C L Cohen

¹Division of Cardiology, Emory University School of Medicine, Atlanta, GA.

Circulation

|November 1, 1991

まとめ

高齢化により,冠動脈外科手術後の合併症や死亡のリスクが著しく増加します. 糖尿病や高血圧などの危険因子も役割がありますが,年齢が最も強い予測因子です.

科学分野:

心血管外科手術についてです.
ゲリアトリック・メディシン (老年医学)
健康に関する研究成果研究成果

背景:

冠動脈外科手術は,高齢者や病気の患者でますます行われています.
合併症と死亡率の予測因子としての年齢は,さらなる評価を必要とする.

研究の目的:

冠動脈バイパス移植 (CABG) の後の合併症と死亡率の予測に対する患者の年齢の影響を評価する.

主な方法:

冠動脈外科手術を受けた13,625人の患者の遡及的分析.
患者様を年齢層 (例えば,40~49,50~59,60~69,70~79,80歳以上) により層分けする.
不良結果の独立した相関性を特定するための多変量分析.

主要な成果:

合併症と死亡率は40歳以降の10年ごとに増加した.
高齢は,神経学的イベント,傷口感染症,死亡の最も強い独立した予測因子でした.
死因の他の有意な相関関係には,緊急手術,女性の性別,心不全の既往歴が含まれています.
術後の心筋梗塞は年齢に関係なく,緊急手術と強く相関していました.

結論:

年齢は,冠動脈外科手術後の結果を予測する上で重要な要因です.
リスク分層モデルには,高齢化や他の相関関係が考慮されるべきです.
更に研究が進めば,CABGを受ける高齢患者のリスク予測を洗練できるかもしれません.

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