术前贫血与选择性开放性大动脉修复后的术后功能衰竭有关
Charles DeCarlo1, Jahan Mohebali1, Anahita Dua1
1Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
The Journal of surgical research
|July 13, 2023
概括
手术前的贫血与开放腹腔大动脉动脉瘤修复 (OAR) 后急性损伤 (AKI) 的风险更高有关. 在手术前治疗贫血可能会减少高风险患者的并发症.
科学领域:
- 血管外科 血管外科
- 腎臟病學 (nephrology) 是一種醫學.
- 麻醉学 麻醉学
背景情况:
- 手术前贫血是心脏手术后急性损伤 (AKI) 的已知危险因素.
- 在开放腹腔大动脉动脉瘤修复 (OAR) 后,术前贫血和AKI之间的关联以前没有被研究过.
研究的目的:
- 确定手术前贫血是否与接受OAR的患者术后AKI风险增加有关.
- 确定干预措施的潜在目标,以减少该患者群体中的AKI.
主要方法:
- 进行了美国外科医生学院国家外科质量改进计划针对性血管模块 (2013-2019) 的回顾性分析.
- 贫血的定义是使用世界卫生组织的标准 (血液值<36%的女性,<39%的男性).
- 使用逆概率加权后勤回归来评估贫血和30天AKI之间的关联,控制患者和手术因素.
主要成果:
- 该研究包括2275名接受OAR的患者;26.3%患有手术前贫血.
- 贫血独立地与术后AKI的更高发病率相关 (OR1.51,95%CI:1.01-2.26,P=0.042) 在倾向权重后.
- 患有AKI的患者在医院住院死亡率明显较高 (26.1%与1.9%,P<0.001).
结论:
- 手术前贫血是OAR后AKI的一个独立风险因素.
- AKI是OAR患者患病率和死亡率的重要因素.
- 在接受OAR的高风险患者中,应考虑进行手术前的贫血或其潜在原因的纠正.
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