种族差异仍然存在,在上和下冠状动脉旁路移植移植后
William A Cooper1, Vinod H Thourani, Robert A Guyton
1Department of Biostatistics, Emory University, Atlanta, Ga., USA. William.cooper@emoryhealthcare.org
Circulation
|September 16, 2009
概括
接受冠状动脉旁路移植 (CABG) 的黑人患者的短期和长期结果更差. 非 CABG (OPCAB) 没有减少这种心脏手术程序的结果的种族差异.
科学领域:
- 心血管外科心血管外科
- 健康差异 在健康上的差异
- 研究成果 研究成果 研究成果
背景情况:
- 种族是冠状动脉旁路移植 (CABG) 后手术死亡的一个确定的风险因素.
- 现有的研究表明,心脏手术结果存在种族差异.
- 在CABG后,种族对不良事件和长期生存的影响需要进一步调查.
研究的目的:
- 评估种族作为首次单独CABG后不良事件和长期死亡的风险因素.
- 确定非 CABG (OPCAB) 是否改变了CABG患者与种族相关的风险.
- 分析CABG手术后的结果中的种族差异.
主要方法:
- 分析了12874个从1997年至2007年的初级分离CABG记录.
- 使用倾向性比分匹配,以平衡心肺绕道OPCAB与CABG的患者组.
- 采用多变量后勤回归和考克斯比例危险模型来评估分别在医院和长期的结果.
主要成果:
- 与白人患者相比,黑人患者 (15.8%) 在3,5年和10年生存率明显较低 (P<0.001).
- 与接受OPCAB的黑人和白人患者相比,与传统CABG患者相比,主要心脏不良事件的风险调整概率降低.
- OPCAB并没有显著改变种族群体之间的结果差异.
结论:
- 与白人患者相比,接受初级隔离CABG的黑人患者的短期和长期结果明显更差.
- 非 CABG (OPCAB) 没有有效地减少黑人和白人个体之间观察到的结果差异.
- 解决心脏外科手术中的种族差异需要进一步的研究,而不仅仅是手术技术的修改.
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