患有心脏性休克的患者的与年龄相关的结局,根据病因分层
Alexander Schmitt1,2, Kathrin Weidner1,2, Jonas Rusnak1,2
1Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Journal of geriatric cardiology : JGC
|September 7, 2023
概括
增加年龄并没有影响所有心脏性休克患者的死亡率. 然而,老年患者患有急性心肌梗塞相关心脏性休克,面临更高的30天死亡风险.
科学领域:
- 心脏病学 心脏病学
- 老年医学 老年医学
- 关键护理医学 关键护理医学
背景情况:
- 心血管疾病患者的人口结构正在向具有复杂并发症的老年人转移.
- 关于晚年对心脏性休克 (CS) 的预后影响的数据有限.
- 这项研究探讨了CS患者年龄的预后意义.
研究的目的:
- 调查年龄对心脏性休克患者30天全因死亡率的预后影响.
- 分析年龄作为CS不同病因的死亡率预测指标.
主要方法:
- 对连续的CS患者 (2019-2021) 进行了30天全因死亡率分析.
- 年龄组 (60-80岁和>80岁) 进行了比较.
- 统计分析包括斯皮尔曼相关性,卡普兰-梅尔和多变量考克斯回归,风险评估按CS病因分层,特别是急性心肌梗塞 (AMI).
主要成果:
- 在223名CS患者中 (平均年龄为77岁),没有发现年龄组之间的30天死亡率有显著差异 (54.6%与63.4%,P=0.169).
- 在急性心肌梗塞相关的CS小组中,80岁以上的患者显示30天死亡风险显著增加 (78.1%对60.0%,P=0.032).
- 在老年AMI-CS患者中,这种风险增加在多变量调整后仍然显著 (HR=2.072,P=0.012).
结论:
- 年龄不是30天死亡率的重要预测因素,混合病因心脏性休克.
- 高龄 (>80岁) 是30天死亡风险增加的重要独立预测因素,特别是在患有急性心肌梗塞相关心脏性休克的患者中.
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