体质指数对冠状动脉旁路手术后的长期生存的影响:一个竞争性的风险分析
Armando Abreu1,2, José Máximo1,2, Francisca Saraiva1
1Cardiovascular R&D Center-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal.
Interdisciplinary cardiovascular and thoracic surgery
|September 23, 2023
概括
这项研究没有发现任何证据表明肥胖会在冠状动脉旁路移植手术后的患者中防止长期死亡. 长期来看,肥胖并没有影响全因,心血管或非心血管死亡率.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 临床研究 临床研究
背景情况:
- 肥胖悖论,一种现象,肥胖似乎保护死亡率,已在各种慢性疾病中观察到.
- 它在接受冠状动脉旁路移植 (CABG) 手术的患者中的存在仍然是研究领域.
研究的目的:
- 调查一次性隔离CABG手术后长期死亡的肥胖悖论.
- 确定任何观察到的死亡率差异是否与心血管或非心血管原因有关.
主要方法:
- 在2000年至2015年期间,对5242名接受初级隔离CABG的患者进行了回顾性分析.
- 长期所有原因死亡率和特定原因死亡率 (心血管和非心血管) 用考克斯回归和特定原因危险模型进行评估.
- 身体质量指数 (BMI) 被分类和连续分析.
主要成果:
- 在BMI类别之间没有发现15年全因,心血管或非心血管死亡率的显著差异.
- 多变量模型证实,当BMI被视为一个分类变量时,类别之间没有差异.
- 当BMI是连续的时,确定了25.830.3公斤/平方米的最佳范围,最低点约为28.9公斤/平方米.
结论:
- 这种人口层面的分析没有支持肥胖对接受孤立初级CABG的患者长期生存的保护作用.
- 这些发现表明,肥胖悖论在这个特定的患者队列中并不明显.
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