在接受过导管大动脉置换的患者中,基线贫血的影响:预后系统性审查和元分析
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Elena Jiménez-Xarrié1, Lluis Asmarats1, Marta Roqué-Figuls2
1Cardiology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau), 08025 Barcelona, Spain.
Journal of clinical medicine
|September 28, 2023
概括
在接受过导管大动脉置换 (TAVR) 的患者中,先前存在的贫血显著增加了输血,急性损伤和短期和中期死亡的风险.
科学领域:
- 心脏病学 心脏病学
- 老年医学 老年医学
- 通过导管进行大动脉替换.
背景情况:
- 严重的大动脉狭窄症通常需要通过导管进行大动脉置换 (TAVR),特别是在75岁及以上的患者中.
- 手术前贫血是TAVR候选人的常见并发症,可能会影响手术结果.
研究的目的:
- 进行预后系统审查,评估基线贫血与TAVR后短期和中期结果之间的关联.
- 量化先前存在的贫血对TAVR后并发症和死亡率的影响.
主要方法:
- 在PubMed和Web of Science上对2013年1月至2022年12月期间发表的研究进行了系统的文献搜索.
- 包括11项包括12,588名患者的观察性研究.
- 用随机效应模型分析数据,以评估结果,包括输血率,急性损伤,死亡率和再录取.
主要成果:
- 在不同研究中,基线贫血的患病率在39%至72%之间.
- 贫血与输血 (OR: 2.95),急性损伤 (OR: 1.74),短期死亡率 (OR: 1.47) 和中期死亡率 (OR: 1.89) 的增加相关.
结论:
- 基线贫血是TAVR后不良结果的显著独立预测因素.
- 患有手术前贫血的患者面临更高的并发症和死亡风险,这凸显了这一群体需要贫血管理的必要性.
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