人种与门置换手术后的死亡率和发病率之间的关系
Nyali E Taylor1, Sean O'Brien, Fred H Edwards
1Department of Surgery, the University of Pennsylvania Health System, Philadelphia, Pa 19104, USA.
Circulation
|March 17, 2005
概括
黑人种族在动脉置换 (AVR) 或心心置换 (MVR) 后的手术死亡率不是一个显著的预测因素. 然而,它与某些并发症的风险增加有关,包括长时间通风和功能衰竭.
科学领域:
- 心血管外科心血管外科
- 医疗保健服务研究 医疗服务研究
- 在医疗保健中的种族差异.
背景情况:
- 以前的研究表明,黑人种族是冠状动脉旁路手术后手术死亡率增加的预测因素.
- 黑人人中高血压和左心室缩的更高发病率表明,在动脉置换 (AVR) 或心心置换 (MVR) 后,风险可能会增加.
研究的目的:
- 通过使用多变量模型来评估隔离AVR或MVR后种族和手术死亡率和发病率之间的关联.
- 调查种族是否是AVR或MVR后不良结果的独立预测因素.
主要方法:
- 胸部外科医生协会国家心脏病数据库 (1999-2002) 的回顾性审查.
- 分析包括3137名黑人和46,249名接受隔离AVR或MVR的白人患者.
- 多变量逻辑回归调整为共变量,以评估种族与死亡/发病率之间的关联.
主要成果:
- 在隔离AVR或MVR后,黑人种族不是手术死亡率的重要预测因素.
- 黑人种族与延长通风,延长术后停留 (>14天),因出血重新手术 (AVR) 和术后功能衰竭 (MVR) 的风险增加有关.
- 种族与中风或深胸部伤口感染风险之间没有发现显著的关联.
结论:
- 种族不是隔离AVR或MVR后手术死亡率的重要预测因素,这与冠状动脉旁路手术的发现相反.
- 黑人种族与AVR或MVR后的特定术后并发症之间存在关联.
- 可能需要进一步的研究来理解和减轻这些已识别的种族差异并发症.
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