女性特有的体型值和在选择性腹腔大动脉瘤修复中死亡率的关联
Mareia Talvitie1,2, Magnus Jonsson1,2, Joy Roy1,2
1Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
The British journal of surgery
|November 14, 2023
概括
修复女性腹腔大动脉动脉瘤 (AAA) 的直径较小,并不能降低死亡率. 尽管女性的破裂风险更高,但女性的最佳修复值仍然未被定义.
科学领域:
- 血管外科 血管外科
- 大动脉动脉瘤研究研究
- 临床结果研究研究
背景情况:
- 关于女性早期腹腔大动脉动脉瘤 (AAA) 修复的死亡益处存在不确定性.
- 现有的指导方针没有明确地定义女性患者的最佳修复值.
研究的目的:
- 在接受小直径和大直径选择性AAA修复的妇女中比较短期和中期死亡率.
- 调查AAA大小对女性死亡结果的影响.
主要方法:
- 从瑞典国家血管外科注册局 (2008-2022) 分析了1642名接受选择性AAA修复的妇女.
- 在接受小直径 (49-54毫米) 和大直径 (≥55毫米) 治疗的妇女之间,90天,1年和3年死亡率的比较.
- 使用后勤回归和倾向得分模型,根据年龄,并发病,吸烟和修复方式进行调整. 男人同时进行了分析.
主要成果:
- 在接受小AAA直径和大AAA直径修复的妇女之间,没有观察到90天,1年或3年死亡率的显著差异.
- 多变量模型显示,AAA大小与女性死亡率之间没有一致的关联.
- 与男性相比,死亡率的性别差异主要是由年轻女性驱动的,特别是在3年结果中.
结论:
- 在接受AAA修复的妇女中,死亡率很高,并且在修复时不受动脉瘤大小的影响.
- 这项研究没有定义女性AAA修复的最佳直径值.
- 女性中破裂风险较高不应该自动导致更低的,女性特有的修复值.
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