在心脏手术中与手术前贫血相关的风险:多中心队列研究
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
概括
术前贫血,手术前的常见情况,独立增加心脏手术患者的不良结果的风险. 需要进一步的研究来探索贫血的治疗方法,以改善患者的结果.
科学领域:
- 心脏病学 心脏病学
- 麻醉学 麻醉学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 手术前的贫血是红细胞输血的已知危险因素.
- 输血与术后发病率和死亡率的增加有关.
- 术前贫血对心脏手术结果的独立影响尚不清楚.
研究的目的:
- 确定手术前贫血是否是心脏手术后不良结果的独立风险因素.
- 量化术前贫血与住院死亡,中风或急性损伤的复合结果之间的关联.
主要方法:
- 在3500名连续心脏手术患者的多中心队列研究中.
- 评估了贫血 (血红蛋白<12.5 g/dL) 的发生率.
- 多变量后勤回归和倾向性得分匹配用于调整混因素.
主要成果:
- 在7所学术医院,手术前贫血的患病率为26%.
- 贫血与2.0倍增加的不良结果风险 (调整后的几率比率) 独立相关.
- 风险调整后的赔率比率在1.8到2.0之间,这表明存在显著的关联.
结论:
- 手术前贫血是心脏手术中不良结果的独立预测因素.
- 对贫血治疗疗法的进一步研究是有必要的,以改善患者的预后.
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