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系统性炎症反应指数在急性甲型大动脉剖析中的预后值
Hongjie Xu1, He Wang1, Lujia Wu1
1Department of Cardiovascular Surgery, Changhai Hospital, The Naval Medical University, 168 Changhai Road, Shanghai, 200433, China.
World journal of surgery
|May 27, 2023
概括
手术前系统性炎症反应指数 (SIRI) 有效预测接受开放手术的急性A型大动脉解剖 (ATAD) 患者的住院死亡率. 较高的SIRI水平与增加的死亡率和术后并发症相关,有助于风险分层.
科学领域:
- 心血管外科心血管外科
- 炎症生物标志物 炎症生物标志物
- 大动脉疾病 大动脉疾病
背景情况:
- 急性甲动脉解剖A型 (ATAD) 是一种危及生命的疾病,需要迅速的外科干预.
- 评估手术前的风险因素对于优化ATAD开放手术后的患者结果至关重要.
- 系统性炎症标志物在ATAD中的预后作用仍然是积极研究的领域.
研究的目的:
- 为了评估手术前系统炎症反应指数 (SIRI) 的预后意义,在接受ATAD开放手术的患者中.
- 确定SIRI是否可以预测本患者队列的住院死亡率和术后并发症.
- 确定SIRI作为在ATAD管理中风险分层的潜在生物标志物.
主要方法:
- 追溯分析了一组410名在2019年至2021年间接受了开放性手术的ATAD患者.
- 考克斯回归和接收器运行特征 (ROC) 曲线分析被用来评估SIRI在住院死亡率的预后价值.
- 卡普兰-梅尔分析和限制立方脊柱分析被用来评估SIRI水平和死亡率之间的关系,以及特定的并发症.
主要成果:
- 整体住院死亡率为14.4%.
- 术前SIRI显示在住院死亡率方面具有显著的预后作用 (AUC = 0.718,p < 0.001).
- 增加的SIRI (≥9.43) 与增加的住院死亡率,冠状动脉鼻撕裂,功能衰竭和感染有关.
结论:
- 术前SIRI作为一个有价值和独立的预测器,在接受开放性手术的ATAD患者的住院死亡率.
- 在手术前风险分层和指导ATAD患者临床管理策略方面,SIRI是一个有前途的生物标志物.
- 将SIRI评估纳入术前评估可能会改善患者的治疗结果和资源分配.
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