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预测与MELD-XI得分的短期心室辅助装置植入后的结果
Tara Pidborochynski1, Sabin J Bozso2, Holger Buchholz2
1Department of Pediatric Cardiology, University of Alberta, Edmonton, Alberta, Canada.
Artificial organs
|July 21, 2023
概括
MELD-XI得分适度预测在接受短期连续流室辅助器件 (STCF-VADs) 的患者中未成功断奶. 虽然它不是出血的强烈预测因素,但它有助于对STCF-VAD治疗的风险分层.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 移植手术 移植手术
背景情况:
- 短期持续流动心室辅助装置 (STCF-VADs) 对于管理心脏性休克至关重要,但高死亡率仍然存在.
- 以前的研究将高的手术前MELD-XI得分与持久VAD接受者的死亡率联系起来.
- 对于STCF-VAD结果的MELD-XI的预测价值仍然没有被探索.
研究的目的:
- 研究在接受STCF-VAD植入的成年人中MELD-XI得分和患者结果之间的关系.
- 评估MELD-XI在预测死亡率,出血和设备断奶成功方面的实用性.
主要方法:
- 从2009年至2019年,对成人STCF-VAD接受者的回顾性审查.
- 接收器操作特征 (ROC) 分析以确定结果的预测准确性.
- 卡普兰-梅尔分析以评估基于MELD-XI得分的生存率.
主要成果:
- 在79名被纳入的患者中,观察到MELD-XI得分的中位数为21.2.
- 较高的植入前MELD-XI得分与不成功的设备断奶 (p<0.001) 和严重的术后出血 (p=0.03) 相相关.
- 对于未成功的断奶,MELD-XI显示了适度的预测价值,对出血预测的效用有限.
结论:
- 手术前的MELD-XI得分是STCF-VAD患者设备断奶失败的中等预测.
- 在这个人群中,MELD-XI评分对预测出血并发症的有用性有限.
- 这种评分系统可以帮助临床医生在植入前风险分层和STCF-VAD治疗患者咨询.
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