在接受主动脉手术的非常老年人的长期存活率
Donald S Likosky1, Meredith J Sorensen, Lawrence J Dacey
1Department of Surgery, Dartmouth-Hitchcock Medical Center, Hanover, NH, USA. donald.likosky@dartmouth.edu
Circulation
|September 16, 2009
概括
动脉置换 (AVR) 和冠状动脉旁路移植 (CABG) 手术的AVR后的存活率对八十岁的人来说是有利的. 超过一半的80岁以上的患者存活超过6年,CABG不会对生存产生负面影响.
科学领域:
- 心脏病学 心脏病学
- 老年人手术是一门老年手术.
- 研究成果 研究成果 研究成果
背景情况:
- 越来越多的老年人正在接受大动脉门手术.
- 这项研究侧重于这个特定患者群体中的短期和长期存活率.
研究的目的:
- 为了评估接受大动脉门手术的非常老年患者的生存率.
- 在80岁及以上的患者中,比较隔离性大动脉置换 (AVR) 和AVR与并发性冠状动脉旁路移植 (CABG) 手术之间的结果.
主要方法:
- 一项队列研究包括了7584名在1987年至2006年期间接受了开放性大动脉手术的患者.
- 分析了患者记录,并将其与社会保障管理局的死亡主文件联系起来,以获取幸存者数据.
- 生存率按年龄组 (<80,80-84,>=85岁) 和手术类型 (AVR与AVR + CABG) 分层.
主要成果:
- 在39835个人年的随访中,发生了2877例死亡.
- 隔离AVR的中位生存时间为11.5年 (<80),6.8年 (80-84) 和6.2年 (>=85).
- 对于AVR + CABG的中位生存时间为9.4年 (<80),6.8年 (80-84) 和7.1年 (>=85),年龄显著影响生存 (P<0.001).
结论:
- 在接受大动脉门手术的八十多岁人群中,存活率是有利的,超过一半的存活时间超过6年.
- 同时进行CABG手术似乎不会降低80岁以上患者的中位生存率.
- 这些发现表明,仅仅是晚年不应该是这些手术的禁忌.
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