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90岁以上接受心脏起器植入的患者的短期和长期存活率
Massimo Zecchin1, Boris Trevisan, Chiara Baggio
1Cardiovascular Department, Azienda Sanitaria Universitaria Integrata Giuliano Isontina, University of Trieste, Trieste, Italy.
Journal of cardiovascular medicine (Hagerstown, Md.)
|August 22, 2023
概括
在90岁及以上的患者中植入心脏起器显示出出色的一年生存率,超过了一般人口的预期. 影响生存的关键因素包括瘤和神经相关疾病,以及功能障碍.
科学领域:
- 心脏病学 心脏病学
- 老年医学 老年医学
- 医疗器械 医疗器械
背景情况:
- 对于非常老年患者 (≥90岁) 进行心脏起器植入的益处尚不清楚,在这个年龄组的意大利普通人口中,12个月生存率为26%.
- 了解老年患者心脏起器植入的结果和生存因素对于临床决策至关重要.
研究的目的:
- 分析90岁或以上的患者进行首次心脏起器植入的临床特征,结果和生存预测指标.
- 评估心脏起器植入器在一个非常老年人队伍中的有效性和安全性.
主要方法:
- 对年龄≥90岁的患者进行了临床参数,设备特征和生存数据的回顾性评估,这些患者在2019年至2020年期间接受了心脏起器.
- 采用多变量分析来确定与死亡率和短期结果相关的因素.
主要成果:
- 在554个心脏起器植入物中,69个 (12%) 是90岁以上的患者,主要是由于晚期心房阻塞 (65%).
- 12个月死亡率的概率为24.6%,癌症和神经病并发症与死亡率显著相关 (HR分别为5.31和6.44).
- 短期结果 (6个月) 受功能障碍,抗凝剂治疗,瘤并发症和左心室喷射小部分的影响.
结论:
- 在90岁及以上的患者中植入心脏起器,主要用于先进的心房阻塞,表现出极好的一年生存率,超过了一般人群的估计.
- 癌症和神经系统并发症是这一群体死亡率的重要预测因素.
- 这项研究强调了在评估老年人心脏起器植入时考虑并发症和功能的重要性.
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