在接受急性高风险腹部手术的患者中,托罗邦素I水平与死亡率之间的关联-A队列研究
Charlotte Tiffanie Bendtz Kanstrup1,2, Camilla Mattesen Serup1,3, Kristina Johansen Svarre1,3
1Department of Surgery, Copenhagen University Hospital - North Zealand, Hillerød, Denmark.
World journal of surgery
|January 29, 2024
概括
非心脏手术 (MINS) 后的心肌损伤在高风险腹部手术后很常见,并显著增加死亡风险. 热素I水平的动态变化没有影响这个患者组的死亡结果.
科学领域:
- 心脏病学 心脏病学
- 在外科手术期间的医学.
- 胃肠道手术 胃肠道手术
背景情况:
- 非心脏手术 (MINS) 后的心肌损伤与死亡率有关,但在急性高风险腹部手术中未得到充分研究.
- 手术后心脏生物标志物的动态变化的影响仍然不清楚.
研究的目的:
- 确定在接受急性高风险胃肠道手术的患者中MINS的发病率.
- 评估MINS与30天/1年死亡率之间的关联.
- 调查血热素I (TnI) 动态对死亡率的影响.
主要方法:
- 对341名接受急性高风险胃肠道手术的患者进行前性队列研究.
- 血TnI每天测量四个术后天;MINS定义为TnI>59 ng/L.
- 通过特定的增加/减少值定义的动态TnI变化;使用治疗权重和竞争性风险分析的逆概率调整的死亡率.
主要成果:
- MINS发生率为23.8%;动态TnI变化发生在15.6%的患者中.
- 显着与更高的未调整和调整后30天和1年死亡率相关联 (p < 0.001).
- 在具有或没有动态TNI变化的患者之间没有观察到死亡率的显著差异.
结论:
- 在急性高风险腹部手术后,MINS是常见的,也是增加死亡率的重要预测因素.
- 血TnI监测可以识别高风险患者,潜在地改善护理.
- 对MINS的预防策略和治疗方法进行进一步的研究是必要的.
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