固体器官移植与急性椎炎复发之间的关联:国家评估
Noah J Harrison1, Lauren R Samuels2, Stacie B Dusetzina3
1Section of Colon & Rectal Surgery, Division of General Surgery, Vanderbilt University Medical Center, Nashville, TN.
Annals of surgery
|November 20, 2023
概括
固体器官移植的接受者并不面临复发性急性分泌体炎的更高风险. 这项研究发现,移植患者和其他人之间的复发率或严重程度没有显著差异,这挑战了积极的切除术策略.
科学领域:
- 胃肠病学 胃肠病学
- 移植手术 移植手术
- 流行病学 流行病学
背景情况:
- 固体器官移植 (SOT) 接受者通常被认为有较高的严重和复发性急性分泌体炎的风险.
- 目前对SOT患者的胆管切除术的指导方针是基于有限的单中心数据.
- 这项研究解决了对免疫受损人群中分泌体炎结局的更广泛证据的需求.
研究的目的:
- 为了比较在有或没有有过固体器官移植病史的患者中复发性急性椎炎的发生率和严重程度.
- 为了评估二次结果,如住院,切口术和口术在复发性分泌体炎后的比率.
主要方法:
- 从2014年至2020年间,对170,697名被诊断患有急性椎炎的患者进行了回顾性分析,这些数据来自Merative MarketScan.
- 患者根据固体器官移植 (SOT) 病史进行了分层.
- 用反向概率权重来控制混变量;主要结果是一年内复发.
主要成果:
- 在170,697名患者中,442名 (0.2%) 患者有SOT病史.
- 在加权队列中,一年复发率为22% (95%CI:20%-25%),在SOT和非SOT组之间没有发现显著差异 (HR=1.19;95%CI:0.94-1.50).
- 由于复发性分泌体炎,住院率,住院时间和出院状态在各组之间也相似.
结论:
- 这项全国性分析表明,在有或没有有过固体器官移植病史的患者之间,急性椎炎复发率没有统计学上显著的差异.
- 这些发现不支持仅仅基于SOT身份的侵略性切除术策略,因为担心复发或严重性增加.
- 进一步的研究可能会探索SOT人口中的特定风险因素.
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