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移植具有堆叠风险的候选人会对结果产生负面影响
Edward Cantu1, Dun Jin1, Madeline McCurry1
1Division of Cardiovascular Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
概括
肺移植接受者的并发症增加加剧了结果,包括较高的死亡率,更长的住院时间和成本增加. 了解这些堆叠的风险对于改善肺移植后的患者护理至关重要.
科学领域:
- 医学研究 医学研究
- 移植手术 移植手术 移植手术
- 分析健康结果分析
背景情况:
- 肺移植 (LT) 中心面临越来越多的患有多种风险因素的患者.
- 累积风险对移植后结果的影响尚不清楚.
- 评估并发症负担与患者结果之间的关系至关重要.
研究的目的:
- 确定伴随性疾病数量与肺移植后结果之间的关联.
- 量化堆叠风险对死亡率,住院时间和医院费用的影响.
- 分析并发症数量对患者出院处置的影响.
主要方法:
- 使用国家住院患者样本 (NIS) 和UNOS Starfile (USF) 数据库 (2016-2019) 的回顾性队列研究.
- 应用概率匹配算法来链接患者记录.
- 用以识别并发症的Elixhauser方法;使用处罚立方线,Kaplan-Meier和回归分析.
主要成果:
- 总共有1821名肺移植接受者被分析.
- 伴随性疾病组 (低<3,中等3-6,高>6) 在结局上表现出显著差异.
- 住院患者死亡率 (1.6%至7.0%),住院时间 (16至29天),总费用和熟练护理机构出院率随着伴随病情数量增加而增加.
结论:
- 累积的并发症 (堆叠的风险) 对肺移植后的死亡率,住院时间和医院费用产生负面影响.
- 较高的并发症负担与出院到熟练护理机构的可能性增加有关.
- 需要进一步的研究,以阐明不同堆叠风险对肺移植接受者的具体影响.
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