经过心脏手术的晚期肝病患者的结果
Ingi Pétursson1, Andrea Amabile2, Ellelan Degife2
1Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavík, Iceland.
JTCVS open
|January 11, 2024
概括
晚期肝病 (LD) 对接受心脏手术的患者显著增加风险,包括更长的住院时间和更高的死亡率. 选择的患有较不严重的肝病的患者仍然可能具有可接受的外科手术结果.
科学领域:
- 心脏病学 心脏病学
- 肝病学 肝病学是一种肝病学.
- 外科手术的结果
背景情况:
- 肝病 (LD) 是一般和心脏手术中不良结果的已知危险因素.
- 目前的心脏手术风险评估工具没有充分纳入LD.
- 有限的研究存在于先进的LD对心脏手术结果的具体影响.
研究的目的:
- 评估心脏手术患者中晚期肝病和劣质结局之间的关联.
- 确定与晚期LD患者30天死亡率相关的特定风险因素.
主要方法:
- 一个回顾性,单中心观察性研究,对285名经过心脏手术的LD患者进行了观察 (2010-2020年).
- 根据末期肝病模型 (MELD) 评分,患者被分为儿童-图尔科特-普格 (CTP) A类,早期B类和高级B类.
- 使用后勤回归分析来确定30天死亡率的预测因素.
主要成果:
- 晚期B类LD的患者经历了更长的住院时间 (14天),更高的长时间通风率 (46.9%),功能衰竭 (21.9%) 和30天/住院死亡率 (18.8%).
- 术后并发症的发生率在高级B类 (59.4%) 比CTP类A (37.9%) 和早期B类 (38.2%) 高.
- 女性性别和外周血管疾病是晚期LD患者30天死亡率的独立预测因素.
结论:
- 肝病的严重程度显著影响心脏外科手术中的术后结果.
- 患有CTP类A和选择的CTP类B (MELD得分<12.7) 肝病的患者可以接受心脏手术,风险可接受.
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