隔离性大动脉门手术后低心输出综合征的预测因素
Manjula D Maganti1, Vivek Rao, Michael A Borger
1Division of Cardiovascular Surgery, Toronto General Hospital, University of Toronto, Ontario, Canada.
Circulation
|September 15, 2005
概括
大动脉手术后的低心力输出综合征 (LCOS) 是由功能衰竭,减少喷射率和女性性别等因素预测的. 识别这些预测因素可以改善患者的治疗结果并降低死亡率.
科学领域:
- 心血管外科心血管外科
- 临界护理医学 临界护理医学
- 心脏麻醉心脏麻醉
背景情况:
- 低心输出综合征 (LCOS) 是主动脉 (AV) 手术后的常见并发症.
- 它是由手术后需要机械支持或内性剂的需求来定义的.
- 确定手术前预测因素对于风险分层和风险管理至关重要.
研究的目的:
- 确定在接受隔离AV手术的患者中LCOS的独立术前预测因子.
- 分析与这组患者手术后死亡率相关的因素.
主要方法:
- 对前性输入机构数据库的回顾性审查.
- 在1990年至2003年间,对2255名接受隔离心房外科手术的患者进行了分析.
- 逐步后勤回归用于识别LCOS和手术死亡率的独立预测因素.
主要成果:
- 这种LCOS的患病率为3.9%.
- LCOS的独立预测因素包括功能衰竭 (OR 5.0),较早的一年 (OR 4.4),LVEF <40% (OR 3.6),休克 (OR 3.2),女性性别 (OR 2.8) 和年龄增加 (OR 1.02).
- 手术后死亡率为2.9%,在LCOS患者中显著高 (38%对1.5%).
结论:
- 在AV手术后,LCOS显著增加了患病率和死亡率.
- 建议采取专注于维护功能,优化心力衰竭和避免假肢与患者不匹配的策略.
- 这些干预措施可以减少LCOS的发生率并改善外科手术的结果.
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