在破裂腹腔大动脉动脉瘤修复后多器官衰竭的特征
Muhammad Saad Hafeez1, Shimena R Li2, Katherine M Reitz3
1Division of Vascular Surgery, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA.
Journal of vascular surgery
|June 29, 2023
概括
在破裂腹腔大动脉瘤 (rAAA) 修复后的多器官衰竭 (MOF) 在9-14%的患者中发生,显著增加死亡率. 内血管修复与MOF的发病率较低有关.
科学领域:
- 血管外科 血管外科
- 关键护理医学 关键护理医学
- 手术结果研究研究.
背景情况:
- 多器官衰竭 (MOF) 是一种已知的并发症,在败血症和创伤中死亡率高.
- 在破裂腹腔大动脉瘤 (rAAA) 修复后的MOF患病率和特征的数据有限.
- 本研究探讨了rAAA后MOF修复的当代患病率和患者概况.
研究的目的:
- 为了确定多器官衰竭 (MOF) 的发生率和特征,患者接受腹腔大动脉动脉瘤破裂 (rAAA) 修复.
- 为了评估MOF和rAAA修复后30天死亡率之间的关联.
- 为了确定MOF的预测因素,包括手术修复的类型.
主要方法:
- 在2010-2020年间接受rAAA修复的患者的回顾性审查.
- 排除在治疗后48小时内死亡的患者.
- 使用丹佛,SOFA和MODS得分 (术后3-5天) 量化MOF;MOF由特定得分值定义.
- 卡普兰-梅尔分析和后勤回归用于评估死亡率和预测因素.
主要成果:
- 在288名符合条件的患者中,MOF患病率为14.24% (丹佛),9.03% (SOFA) 和13.54% (MODS).
- 肺部和神经系统在MOF患者中最常受到影响.
- MOF与30天死亡率的增加显著相关 (10.8%与35.7%,P <.01).
- 较高的BMI和手术前中风与MOF相关;内血管修复具有保护性 (OR 0.23,P = .019).
结论:
- 在rAAA修复后,MOF发生在9-14%的患者中,并与死亡率增加三倍有关.
- 内血管修复表明MOF的发病率降低.
- 需要进一步研究rAAA修复后的MOF预防和管理.
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