患者报告结果的预后价值在透过导管大动脉置换后预测长期死亡率
Hasan S Alarouri1, Ahmed El Shaer2, Alejandra Chavez Ponce1
1Department of Cardiovascular Disease Mayo Clinic Rochester MN USA.
Journal of the American Heart Association
|September 26, 2023
概括
经过过导管大动脉置换后,堪萨斯城心肌病问卷12 (KCCQ-12) 评分的显著改善与更好的长期存活有关. 适度或没有KCCQ-12改善表明术后死亡风险较高.
科学领域:
- 心脏病学 心脏病学
- 健康 结果 研究 研究 结果
- 医疗干预 医疗干预
背景情况:
- 患者报告的结果测量 (PROM) 对于预测心脏干预后的预后至关重要.
- 堪萨斯城心肌病问卷12 (KCCQ-12) 是评估心力衰竭患者生活质量的关键PROM.
研究的目的:
- 为了评估KCCQ-12得分的变化后转导管大动脉置换 (TAVR) 和长期死亡率之间的关联.
- 确定Delta KCCQ-12是否是TAVR后一个有价值的预后指标.
主要方法:
- 从2012年2月到2022年6月接受TAVR的1124名患者的回顾性分析.
- 根据KCCQ-12得分在手术后30-45天的改善情况分组患者:显著 (>+19),适度 (1-19),或没有 (≤0) 变化.
- 在不同组中对生存分析和风险调整后死亡率进行了比较.
主要成果:
- 平均KCCQ-12的改善为19±24分;46.3%的人取得了显著的改善.
- 显著改善KCCQ-12 (5.7年) 的患者的中位生存时间明显高于适度改善 (5.1年) 或没有改善 (4.1年) 的患者.
- 与显著改善的患者相比,KCCQ-12改善程度较小或没有改善的患者的调整后死亡风险明显更高 (HR分别为1.54和2.30).
结论:
- 在TAVR后KCCQ-12得分的显著改善与更好的长期存活有关.
- 德尔塔KCCQ-12作为一种有效和高效的工具,用于识别长期死亡风险增加的TAVR患者.
相关概念视频
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
23
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
23
Aortic Regurgitation IV: Nursing Management
30
A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
30
Mitral Valve Prolapse II: Assessment and Management
20
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
20
Aortic Regurgitation III: Medical Management
24
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
24
Aortic Regurgitation I: Introduction
10
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
10
Mitral Stenosis IV: Nursing Management
14
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
14


