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晚期心力衰竭的机械循环支持:患者选择对结果的影响
M C Deng1, M Loebe, A El-Banayosy
1Cardiothoracic Surgery and Transplant Center, Westfalian Wilhelms University Münster, Münster, Germany. md785@columbia.edu
Circulation
|February 24, 2001
概括
患者选择左心室辅助系统 (LVAS) 对晚期心力衰竭的生存至关重要. 识别植入前的风险因素,如呼吸衰竭和年龄,会对结果产生重大影响.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 心脏衰竭管理的管理
背景情况:
- 自1993年以来,可穿戴左心室辅助系统 (LVAS) 的使用在晚期心力衰竭中增加了.
- 在欧洲,LVAS的可用性促使其在临床实践中得到更广泛的采用.
研究的目的:
- 为了确定影响LVAS植入后生存的患者选择因素.
- 分析未经选择的LVAS接收者队列中的结果.
主要方法:
- 使用了来自Novacor欧洲注册 (1993-1999) 的数据,其中包括464名LVAS受益人.
- 对366名患者的子集进行了多变量分析,具有完整的数据.
- 确定了植入前条件作为生存的独立风险因素.
主要成果:
- 死亡的关键风险因素包括带有呼吸衰竭的败血症 (OR 11.2),右心衰竭 (OR 3.2) 和65岁以上的年龄 (OR 3.01).
- 急性心脏切除术后 (OR 1.8) 和急性心脏病发作 (OR 1.7) 也是显著的危险因素.
- 没有风险因素的患者的一年生存率为60%,至少有一个风险因素的患者的生存率降至24%.
结论:
- 在临终前仔细选择患者对于改善LVAS结果至关重要.
- 改善患者管理策略可能会进一步提高晚期心力衰竭的存活率.
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