相关实验视频
在接受内血管大动脉动脉瘤修复用于较小动脉瘤的八代人中增加的死亡率要求谨慎
William Duong1, Areg Grigorian2, Sarah Yuen2
1Division of Vascular and Endovascular Surgery, Department of Surgery, University of California, Los Angeles, Los Angeles, CA.
Annals of vascular surgery
|October 12, 2023
概括
接受内血管动脉瘤修复 (EVAR) 的八岁老年患者面临更高的死亡风险. 在这个群体的腹腔大动脉动脉瘤 (AAA) 选择性EVAR需要仔细考虑,因为风险增加.
科学领域:
- 血管外科 血管外科
- 老年医学 老年医学
- 健康 结果 研究 研究 结果
背景情况:
- 老年患者,特别是80岁以上的患者,代表着日益增长的人口,腹腔大动脉动脉瘤 (AAA) 的患病率越来越高.
- 晚年对内血管动脉瘤修复 (EVAR) 后的结果的影响仍然不完全理解.
- 这项研究研究了晚年作为一个独立的死亡风险因素在八十岁的老年患者 (OGPs) 与非八十岁的老年患者 (NOGPs) 接受EVAR.
研究的目的:
- 为了确定晚年对接受EVAR的老年患者死亡风险的影响.
- 为了比较八十岁的老年患者 (OGPs) 和接受EVAR的非八十岁的老年患者 (NOGPs) 之间的结果.
- 在八十多岁的人群中确定与EVAR相关的特定风险.
主要方法:
- 利用了2011-2017年美国外科医生学院国家外科质量改进计划 (ACS NSQIP) 数据库.
- 包括老年患者 (>65岁) 接受EVAR治疗的症状和无症状腹腔大动脉动脉瘤 (AAA).
- 进行了多变量物流回归分析,以比较OGP和NOGP之间的结果.
主要成果:
- 八分生年龄老年患者 (OGPs) 占研究队列的28.4%,并且更常见的是女性.
- 与NOGP相比,OGP的死亡率 (3.4%对1.7%) 和住院时间明显更高,并且住院时间更长.
- 多变量分析显示,OGP的死亡风险增加 (OR1.88),无论AAA表现如何 (有症状或无症状).
结论:
- 与年轻的老年患者相比,接受EVAR的八分生老年患者 (OGPs) 的死亡风险明显增加.
- 这种增加的死亡风险即使控制了已确定的风险因素,也仍然存在.
- 在八十岁的老年患者中,腹腔大动脉瘤 (AAA) 的选择性EVAR需要谨慎考虑,特别是对于较小的动脉瘤,破裂风险可能不证明程序风险增加是合理的.
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