在接受 Septal Reduction 治疗的患者中,基于年龄的结果
Muddasir Ashraf1, M Fuad Jan1, Arshad Jahangir1
1Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers; University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin.
The American journal of cardiology
|August 27, 2023
概括
接受隔膜缩小治疗的老年人面临更高的死亡风险和永久性起器安置的风险. 这些国家数据突出显示了隔膜肌切除和酒精隔膜切除的基于年龄的结果差异.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 隔膜减小疗法 (SRT) 用于治疗多变性心肌病变.
- 缺乏关于SRT手术年龄特异性结果的国家数据.
- 了解与年龄相关的风险对于患者管理和知情同意至关重要.
研究的目的:
- 评估隔膜切除 (SM) 和酒精隔膜切除 (ASA) 后的住院死亡率和新的永久心脏起器 (PPM) 放置.
- 为了比较经过SRT的不同成年年龄组的结果.
- 为了确定SRT结果中的基于年龄的差异.
主要方法:
- 从2005年到2019年对国家住院样本 (NIS) 数据库的分析.
- 包括接受SM或ASA的成年患者.
- 将患者分成各个年龄段 (如18-39岁,40-64岁,≥65岁) 的分层,以进行结果比较.
主要成果:
- 隔膜肌切除术:在65岁以上的患者中增加了住院死亡率 (OR 4.46),主要是由于并发症. 在老年人群中,新的PPM安置的几率更高 (AOR 3.17-4.39).
- 酒精隔膜切除:在风险调整之前,在最老的组 (≥80岁) 中增加了住院死亡率. 尽管调整了风险,但在老年人群中新增PPM安置的几率更高 (AOR 1.78-3.10).
- 在这两种手术中,对不同年龄段的患者进行了绝对风险估计.
结论:
- 老年成人患者,特别是65岁以上的MS患者,面临着死亡率和PPM安置的显著更高风险.
- 与年龄相关的风险即使在对伴随性疾病的风险调整后仍然存在,特别是在SM和ASA后的PPM安置后.
- 这些国家数据为医疗保健提供者提供了关键的见解,以更好地咨询患者并管理与隔膜缩小疗法相关的基于年龄的风险.
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