在患有先前心血管事件的患者手术后死亡风险
Christos V Chalitsios1, Matthew S Luney2,3, William A Lindsay2,4
1Academic Unit of Lifespan and Population Health, University of Nottingham, Nottingham, United Kingdom.
JAMA surgery
|November 22, 2023
概括
在急性冠状动脉综合征或中风后11.3个月内进行手术会增加术后死亡风险,特别是在选择性手术中. 这一发现有助于平衡心血管事件后的手术时间与患者安全.
科学领域:
- 心血管医学 心血管医学
- 外科手术的结果
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在急性冠状动脉综合征 (ACS) 或中风后,对非心脏手术的最佳时间缺乏共识.
- 术后死亡风险是心血管事件发生后的时间依赖.
研究的目的:
- 量化ACS或中风后30天术后死亡风险增加的持续时间和程度.
主要方法:
- 长度回顾性基于人口的队列研究,使用链接的英语国家卫生数据 (2007-2018).
- 包括接受非心脏,非神经外科手术的成年人,有或没有先前的ACS或中风.
- 多变量后勤回归分析了30天,60天,90天和365天的死亡率.
主要成果:
- 在ACS或中风后11.3个月内进行手术与死亡风险增加有关.
- 选择性手术 (14.2个月间隔) 的风险高于紧急手术 (7.3个月间隔).
- 脑中风的绝对风险高于心肌梗塞,时间依赖的风险间隔相似.
结论:
- 在ACS或中风1年内进行手术会增加术后死亡率,特别是在选择性手术中.
- 这些发现有助于临床医生和患者权衡手术的好处与心血管事件后加速手术的风险.
- 基于心血管事件发生时间的风险分层对于手术决策至关重要.
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