在老年人中植入可移植心脏转换器-除器植入后的存活率
Derek Yung1, David Birnie, Paul Dorian
1University of Toronto, Toronto, ON, Canada. dlee@ices.on.ca
Circulation
|June 19, 2013
概括
接受植入式心脏变压器 (ICD) 的老年患者面临更高的死亡风险. 然而,适当的冲击率在所有年龄组中保持一致,这表明仅仅年龄不应该决定ICD候选人.
科学领域:
- 心脏病学 心脏病学
- 老年医学 老年医学
- 医疗器械 医疗器械
背景情况:
- 在老年人群中,可植入式心脏转换器-除器 (ICD) 的有效性受到争议,可能是由于非失常性死亡原因.
- 这项研究调查了年龄如何影响ICD疗法和患者的治疗结果.
研究的目的:
- 评估年龄对设备提供的疗法和接受初级或二级预防ICD的患者死亡率的影响.
- 为了确定年龄是否仅仅是ICD受益的限制因素.
主要方法:
- 分析了加拿大安大略省5399名ICD患者的潜在注册表.
- 在3.7年的时间里收集了设备治疗和并发症的数据.
- 在不同年龄层 (18-49岁,50-59岁,60-69岁,70-79岁,≥80岁) 的死亡率和适当的休克率进行了比较.
主要成果:
- 在初级和二级预防ICD接受者中,随着年龄的增长,死亡率显著增加.
- 在所有年龄组中,ICD所产生的适当冲击率是相似的.
- 竞争性风险分析证实,随着年龄的增长,死亡风险更高,但适当的冲击率没有显著差异.
结论:
- 老年患者在ICD植入后死亡率增加,但适当的除器冲击在各年龄组中保持一致.
- ICD候选人决定不应该仅仅依赖于时间上的年龄.
- 个体风险因素导致死亡,无论除器治疗,应指导治疗决策.
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