在成功的切除性手术后降低长期死亡率:基于人口的研究
Cecilia Granthon1,2, Anna Edelvik Tranberg1,2, Kristina Malmgren1,2
1Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Journal of neurology, neurosurgery, and psychiatry
|September 21, 2023
概括
手术显著降低了耐药患者的死亡风险. 在手术后实现发作自由对于改善存活率和预防中突然意外死亡 (SUDEP) 至关重要.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 公共卫生 公共卫生
背景情况:
- 研究了经过切除手术的抗药性患者的死亡率,与没有接受切除手术的患者相比.
- 假设手术导致长期死亡率降低.
- 使用了瑞典国家手术登记册和死亡原因登记册的数据.
研究的目的:
- 为了比较经过手术和未经手术的抗药性患者之间的所有原因和相关死亡率.
- 在这个队列中确定死亡率和中突然意外死亡 (SUDEP) 的预测因素.
主要方法:
- 分析了1329名手术和666名未手术的耐药患者的数据.
- 随访时间从2年到20年不等.
- 采用卡普兰-梅尔和考克斯回归分析;对SUDEP病例的尸检报告进行了审查.
主要成果:
- 在中突然意外死亡 (SUDEP) 占所有死亡的30%.
- 手术与所有原因死亡率 (HR 0.7) 的30%降低有关,持续超过15年.
- 在手术患者中,持续性发作 (37%) 和独自生活是死亡风险因素;无发作改善了生存率.
结论:
- 切割性手术与药物耐药患者全因死亡率降低有关.
- 手术后无是减少全因死亡率和SUDEP的最重要因素.
- 这些研究结果支持手术作为在精心挑选的患者中减少死亡率的干预措施.
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