在极老年人中进行动脉内关节切除术:短期,中期和长期的结果
Shabin Fahad1, Sayali Shirsath1, Matthew Metcalfe1
1Herts and West Essex Vascular Network, The Lister Hospital, Hertfordshire, United Kingdom.
Vascular specialist international
|September 25, 2023
概括
关节内关节切除术 (CEA) 对80岁及以上的老年患者是安全有效的. 虽然30天的风险很低,但由于长期生存率,需要对高风险个体进行仔细考虑.
科学领域:
- 血管外科 血管外科
- 老年医学 老年医学
- 神经学 神经学
背景情况:
- 冠状动脉内关节切除术 (CEA) 改善了冠状动脉狭窄症中无中风生存率.
- 老年患者 (≥80岁) 经常因感知到的风险而被排除在试验之外,尽管增加了预期寿命.
- 目前的指导方针没有充分解决CEA对老年人群的好处.
研究的目的:
- 评估CEA在80岁及以上患者的安全性和有效性.
- 评估在这个特定的人口群体中,在CEA后的中风和生存结果.
- 确定影响CEA接受CEA的老年患者结果的因素.
主要方法:
- 追溯审查2016年4月至2022年4月期间执行的CEA程序.
- 包括人口统计数据,并发病,手术和手术细节.
- 收集长期结果和生存数据,直到2023年4月.
主要成果:
- 在258例CEA中,有70例 (27.1%) 是80岁以上 (平均年龄84岁) 的患者.
- 30天中风和死亡率分别为4.3%和1.4%.
- 无中风5年生存率为91.4%,而生存率为61.4%. 患有ASA等级3的患者的长期存活率显著降低 (HR5.29,P<0.01).
结论:
- 对于平均风险的老年患者 (≥80岁) 来说,CEA是一种安全有效的程序.
- 高风险患者 (ASA 3级) 没有增加早期中风或死亡率,但长期存活率较差.
- 仔细的手术前评估至关重要,以权衡CEA的益处与老年人的风险.
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