急性损伤与心胸手术后的长期死亡率增加有关
Charles E Hobson1, Sinan Yavas, Mark S Segal
1Department of Medicine, Division of Thoracic and Cardiovascular Surgery, University of Florida College of Medicine, Gainesville, Fla 32610-0286, USA.
Circulation
|April 29, 2009
概括
心胸手术后的急性损伤 (AKI) 显著增加长期死亡风险,长达10年. 即使是脏完全恢复的患者也面临更高的死亡风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
背景情况:
- 经过急性损伤 (AKI) 后的长期存活情况尚不清楚.
- 研究住院期间小血清肌素变化对心胸外科手术后长期死亡率的影响.
研究的目的:
- 确定心胸外科手术后的长期死亡率和AKI之间的关系.
- 评估AKI严重程度对长期生存的影响.
主要方法:
- 对2973名接受心胸外科手术的患者 (1992-2002) 的回顾性研究.
- 根据RIFLE分类 (风险,伤害,故障) 定义的AKI.
- 使用Cox比例危险回归分析的生存率,与国家社会保障死亡指数相关联.
主要成果:
- 与没有AKI的患者相比,患有AKI的患者的长期存活率明显降低.
- 死亡风险与AKI严重程度成比例增加 (HR为风险1.23,失败为2.14).
- 死亡风险的增加即使在脏完全恢复后也持续存在 (HR 1.28).
结论:
- 与AKI相关的死亡风险增加在心胸外科手术后的10年内持续存在.
- 这种风险存在,无论其他因素如何,即使功能完全恢复.
- 建议加强脏保护策略,并认真监测出院后的功能.
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