在选择性开放腹腔大动脉动脉瘤修复后早期死亡的分析
Thomas W Cheng1, Alik Farber1, Scott R Levin1
1Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA.
Annals of vascular surgery
|May 27, 2023
概括
在开放腹腔大动脉动脉瘤修复后的早期死亡与患者的并发病和手术因素有关. 高体积的中心可以改善这个复杂的程序的结果.
科学领域:
- 血管外科 血管外科
- 改善外科手术的质量
- 患者的治疗结果.
背景情况:
- 在开放腹腔大动脉瘤修复后的死亡率是关键的质量指标.
- 早期的术后死亡可能源于技术问题或病人选择不充分.
研究的目的:
- 分析在选择性开放腹腔大动脉瘤修复后在术后0-2天 (POD 0-2) 发生的住院死亡.
- 在这个患者队列中确定与早期死亡相关的因素.
主要方法:
- 利用了来自血管质量倡议 (2003-2019) 的数据来进行可选的腹腔大动脉动脉瘤修复.
- 将结果分类为POD 0-2死亡,POD 2之后的死亡,以及生存到出院.
- 进行了单变量和多变量统计分析.
主要成果:
- 在7,592次修复中,0.8%的人经历了POD 0-2死亡.
- POD 0-2死亡与更长的脏/内脏缺血时间,近位位,更长的手术时间和更大的血液损失有关.
- 多变量分析将POD 0-2死亡与并发症 (例如,充血性心力衰竭),较低的中心体积,较长的缺血时间和估计的血液损失联系起来.
结论:
- 开放AAA修复后的早期术后死亡 (POD 0-2) 与特定的并发病,中心体积,缺血时间和血液损失有关.
- 将患者转移到大量的大动脉中心可能会提高存活率.
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