术后科佩:在接受重大非心脏手术的患者中预测价值和风险分层 - - 一项前性观察队列研究
Firmin Kamber1,2,3, Sebastian Roth4, Daniel Bolliger5
1Anesthesiology Clinic, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland. firmin.kamber@usb.ch.
Canadian journal of anaesthesia = Journal canadien d'anesthesie
|January 19, 2024
概括
在外科手术期间,素水平可以预测高风险手术患者的重大心脏和脑血管不良事件 (MACCE) 和死亡率. 手术后升高的可佩,特别是在术后的2-4天,与较差的结果有关.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 生物标志物研究 生物标志物研究
背景情况:
- 生物标志物对于术后风险分层至关重要.
- 手术前的可佩与不良事件有关,但手术内数据有限.
- 了解手术后的可佩对结果的影响是必不可少的.
研究的目的:
- 为了研究术前平素度与患者结果之间的关联.
- 评估可佩与30天和12个月死亡率和/或主要心脏和脑血管不良事件 (MACCE) 的相关性.
- 评估平素与外科手术期间心肌损伤 (PMI) 的关系.
主要方法:
- 在接受非心脏手术的中等至高风险成年人中进行前性观察队列研究.
- 测量了手术前,手术后立即和手术后2至4天的科佩和心脏托罗宁水平.
- 对12个月死亡率/MACCE和30天MACCE的随访.
主要成果:
- 在手术前,手术后立即和POD 2-4期间,高水平的可佩与12个月的存活率 (死亡率/MACCE) 较低有关.
- 在POD 2-4的术后科佩与30天的MACCE无生存率有关联.
- 术后立即使用的可佩丁与外科手术期间心肌损伤 (PMI) 有轻微的相关性.
结论:
- 在外科手术期间的可佩丁度可以识别患有死亡和/或MACCE风险的患者.
- 升高的可佩,特别是在术后,是不良结果的重要预测因素.
- 其他风险因素包括修订的心脏风险指数,BMI,手术风险和手术前血红蛋白.
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