双边动脉狭窄影响大血管手术后的术后并发症
Amanda C Filiberto1, Shunshun Miao2,3, Yuanfang Ren2,3
1Department of Surgery, University of Florida, Gainesville, FL, United States of America.
Surgery open science
|July 6, 2023
概括
双边动脉狭窄症 (RAS) 在接受重大血管手术的患者中显著增加了术后急性损伤 (AKI) 和死亡率的风险. 这一发现凸显了RAS作为手术前风险评估的关键因素.
科学领域:
- 血管外科 血管外科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
背景情况:
- 动脉样硬化性动脉狭窄 (RAS) 是血管手术患者的常见偶然发现.
- 在重大非血管手术中,RAS与术后急性损伤 (AKI) 有关.
- 在主要血管手术中,RAS和AKI之间的关联需要进一步研究.
研究的目的:
- 为了调查AKI和手术后并发症的发病率在RAS患者接受主要血管手术.
- 为了比较患有RAS和没有RAS的患者进行大动脉或内脏旁路手术的结果.
主要方法:
- 对200名接受选择性开放性大动脉或内脏绕道手术的患者进行了回顾性队列研究.
- 患者被分为患有和没有术后AKI的组.
- 动脉狭窄症 (RAS) 在术前CTAs上进行评估,定义为≥50%的狭窄症,读者对AKI状态视而不见.
- 进行了单变量和多变量逻辑回归分析.
主要成果:
- 双边RAS在6.2%的患者中存在,单边RAS在17.4%的患者中存在.
- 双边RAS患者经历了100%的术后AKI发病率,而单边或没有RAS患者的AKI发病率为45% (p <0.05).
- 双边RAS独立预测了严重的AKI (OR 5.82),住院死亡率 (OR 5.71),30天死亡率 (OR 10.56) 和90天死亡率 (OR 6.88).
结论:
- 双边动脉狭窄与大血管手术后AKI发病率和死亡率的增加显著相关.
- 双边RAS作为患者不良结果的标志物.
- 术前风险分层应该包括对双边RAS的评估.
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