基于肥胖类别的跨导管大动脉置换的住院治疗结果
Omar Al Wahadneh1, Saad Ur Rahman1, Nmair Alziadin2
1Department of Internal Medicine, Carle Foundation Hospital, Urbana, IL, United States.
Current problems in cardiology
|January 18, 2024
概括
肥胖症不会增加跨导管大动脉置换 (TAVR) 的住院死亡率. 然而,严重的肥胖与更长的住院时间,更高的成本以及心力衰竭和呼吸系统问题等并发症的风险增加有关.
科学领域:
- 心脏病学 心脏病学
- 减肥医学 减肥医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 过导管大动脉置换 (TAVR) 是严重大动脉狭窄的关键治疗方法,特别是在老年人中.
- 关于肥胖对TAVR结果的影响的数据有限.
研究的目的:
- 为了研究体质指数 (BMI) 和TAVR之后的住院结果之间的关联.
主要方法:
- 从国家住院患者样本 (2016-2020年) 中分析了217,300例TAVR住院病例.
- 根据BMI类别对患者的分层.
- 统计分析以比较BMI组之间的结果,并根据相关因素进行调整.
主要成果:
- 在BMI组之间没有观察到医院死亡率的显著差异.
- 第三类肥胖与更长的住院时间 (0.43天) 和更高的成本 (3126美元) 有关.
- 发现心力衰竭恶化的风险增加,血管接入并发症,术后肺部并发症 (肺炎,急性缺氧呼吸衰竭),以及肥胖患者需要非侵入性通风.
- 在患有II类和III类肥胖症的患者中,观察到更高的完全心脏阻塞率和永久心脏起器需求.
结论:
- 虽然TAVR死亡率不受肥胖的影响,但随着BMI的增加,特定的并发症和资源利用率会增加.
- 这些发现强调了需要量身定制的护理策略,以优化肥胖患者的TAVR安全性和结果.
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