慢性心力衰竭的类型是否会影响大动脉置换手术的医院治疗结果?
Talha Mubashir1, John Zaki1, Sin Yeong An1
1Department of Anesthesiology, The University of Texas Health Science Center at Houston, Houston, Texas.
Texas Heart Institute journal
|June 3, 2023
概括
慢性心力衰竭类型对接受过导管大动脉置换 (TAVR) 或手术大动脉置换 (SAVR) 患者的医院死亡率没有显著影响. 扩张性心力衰竭患者的住宿时间更短,成本更低.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 心脏衰竭管理的管理
背景情况:
- 慢性心力衰竭 (HF) 呈现于静心,静心或混合形式,影响患者管理.
- 大动脉狭窄是大动脉置换手术的常见征兆.
研究的目的:
- 为了比较不同类型的慢性心力衰竭患者的住院治疗结果,这些患者接受过导管大动脉置换 (TAVR) 与手术大动脉置换 (SAVR).
主要方法:
- 利用全国住院患者样本数据库 (2012-2015) 来识别患有大动脉狭窄和慢性高血压的患者.
- 员工倾向得分匹配和多变量逻辑回归来分析结果.
- 包括9,879名患有静缩性,静缩性和混合性慢性HF的患者.
主要成果:
- 在TAVR或SAVR的慢性HF类型中,没有观察到医院死亡率的显著差异.
- 腹筋性HF患者的住院时间更短,费用更低.
- 缩性心肌梗塞与急性心肌梗塞和心脏性休克的风险增加有关,但与腹缩性心肌梗塞相比,永久心脏起器植入的风险较低.
结论:
- 慢性心力衰竭类型似乎不是TAVR或SAVR后医院死亡率的重要预测因素.
- 特定的HF类型与某些不良事件的差异性风险有关,指导程序性考虑.
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