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外体膜氧化治疗心脏骤停:年龄是否重要?

Naomi George¹, Krista Stephens², Emily Ball²

¹Department of Emergency Medicine, Division of Critical Care, University of New Mexico School of Medicine, Albuquerque, NM.

Critical care medicine

|October 2, 2023

概括

由于心脏骤停而接受体外心肺复苏 (ECPR) 的患者的住院生存率随着年龄的增加而下降. 在65岁以后,生存率显著下降,即使考虑到疾病严重程度.

科学领域:

心脏病学心脏病学
关键护理医学关键护理医学
复苏科学复苏科学复苏科学

背景情况:

身体外心肺复苏 (ECPR) 是对心脏骤停 (CA) 患者的一种救命干预.
患者年龄对ECPR结果的影响,特别是医院生存率,仍然不完全理解.

研究的目的:

为了研究老年和住院存活率之间的关联,在患者治疗ECPR的CA.
使用大型国际患者登记册来描述ECPR结果中与年龄相关的趋势.

主要方法:

追溯分析来自体外生命支持组织 (ELSO) 登记册的数据.
包括18岁或以上的患者,他们在2016年12月至2020年10月期间接受了CA的ECPR.
主要结局:医院死亡的调整几率比率 (aOR),按年龄组分层 (18-49岁,50-64岁,65-74岁和75岁以上).

主要成果:

总共分析了5120名患者,平均年龄为57岁.
在较老的年龄组观察到生存率明显较低:65-74岁 (aOR,0.68) 和>75岁 (aOR,0.54) 与18-49岁组相比.
敏感性分析证实,与年轻人相比,65岁及以上的个人存活率下降.

结论:

随着年龄的增长,心脏骤停的ECPR后医院生存率随着年龄的增长而减少,特别是在65岁之后.
这些与年龄相关的差异甚至在调整疾病严重程度和并发症后仍然存在.
需要进一步的前性研究来根据观察数据验证这些发现.

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