接受大动脉置换的脆弱和非脆弱老年人的营养不良和死亡率
Michael Goldfarb1, Sandra Lauck2, John G Webb2
1Azrieli Heart Centre (M.G., L.G.R., J.A.), Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Circulation
|July 7, 2018
概括
在接受大动脉置换 (AVR) 的老年人中,营养不良显著增加了一年死亡风险. 营养状况是预测结果的关键因素,强调需要进行干预.
科学领域:
- 心脏病学
- 老年病学
- 营养科学
背景情况:
- 接受大动脉置换 (AVR) 的老年人面临营养不良的风险.
- 术前营养状况与AVR后的中期死亡率之间的联系尚未得到充分证实.
研究的目的:
- 在接受AVR的患者中,研究术前营养状况与1年死亡率之间的关联.
- 评估AVR后营养状况对短期和中期结果的预测价值.
主要方法:
- 在FRAILTY- AVR前性多中心队列研究中,包括1158名接受过导管或手术AVR的患者 (≥70岁).
- 营养状况是使用小型营养评估简单表格 (MNA-SF) 来评估的;脆弱性是通过短性能物理电池来测量的.
- 用多变量回归模型分析了初级结果 (全年死亡率) 和二次结果 (30天复合死亡率/发病率).
主要成果:
- 8. 7% 的患者营养不良,32. 8% 的患者有营养不良的风险.
- 营养不良患者的1年死亡率几乎是3倍 (28%与10%相比).
- 在调整后,程序前营养状况独立预测了1年死亡率 (OR 1. 08每MNA- SF点) 和30天复合结果 (OR 1. 06每MNA- SF点).
结论:
- 在接受AVR的老年人中,治疗前的营养状况与死亡率有显著关联.
- 营养状况是AVR后中期死亡率和短期安全结果的独立预测因素.
- 需要进行进一步的临床试验,以评估营养干预措施对改善该患者群体的结果的有效性.
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