在美国接受心脏手术的八十多岁人群中,没有救援
Sara Sakowitz1, Syed Shahyan Bakhtiyar2, Amulya Vadlakonda3
1Cardiovascular Outcomes Research Laboratories, University of California, Los Angeles, CA. Electronic address: https://twitter.com/sarasakowitz.
Surgery
|August 6, 2023
概括
无法救援,定义为并发症后的死亡率,影响9.2%的八十岁以上的人接受心脏手术. 关键的危险因素包括年龄,女性性别以及诸如心脏,脏和肝脏疾病之类的并发症.
科学领域:
- 心血管外科心血管外科
- 老年医学 老年医学
- 医疗保健质量指标 医疗保健质量指标
背景情况:
- 八代人代表着快速增长的接受心脏手术的人口.
- 这种人群面临着高死亡率和并发症的高风险.
- 了解预测救援失败的因素至关重要,特别是将其作为质量指标.
研究的目的:
- 确定患者和手术因素,与80岁以上的接受心脏手术的80岁以上患者的救援失败有关.
- 分析十年来失败救援的趋势.
主要方法:
- 使用全国再接收数据库 (2010-2020年).
- 包括80岁及以上的患者,首次接受选择性冠状动脉旁路移植或同时进行门手术.
- 开发了多变量回归模型,以确定未能救援的预测因素 (并发症后的死亡率).
主要成果:
- 在有并发症的76,473名患者中,9.2%的患者未能得到救助 (总共562,794人中).
- 发病率从2010年的9.7%下降到2019年的7.6%.
- 重要预测因素包括年龄较大,女性性别,充血性心力衰竭,晚期脏病,肝病,脑血管疾病和结合冠状动脉旁路移植或多手术.
结论:
- 失败的救援仍然是八十多岁的心脏手术患者的一个重大问题,尽管下降趋势.
- 需要新的风险评估和有针对性的干预措施,以进一步降低并发症后的死亡率.
- 医院体积与救援失败无关.
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