在斯坦福A型大动脉剖析患者中,术后ICU停留时间延长的危险因素
Haiyuan Liu1, Shuaipeng Zhang1, Chengxin Zhang1
1Department of Cardiovascular Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, 230061, Anhui Province, China.
Journal of cardiothoracic surgery
|February 3, 2024
概括
紧急手术,手术前尿素度升高,心肺绕道时间延长是斯坦福A型大动脉剖析 (TAAD) 修复后长时间在重症监护室 (ICU) 住院的关键风险因素. 这些因素与较差的患者结果有关,需要积极的管理策略.
科学领域:
- 心血管外科心血管外科
- 胸前大动脉疾病 胸前大动脉疾病
- 密集护理医学 密集护理医学
背景情况:
- 斯坦福A型大动脉解剖 (TAAD) 是一种危及生命的疾病,需要复杂的手术干预.
- 在TAAD手术后长时间停留在重症监护室 (ICU) 与增加的发病率和死亡率有关.
- 识别长时间ICU住院的独立风险因素对于优化患者管理和结果至关重要.
研究的目的:
- 为了确定预测TAAD手术后长时间ICU停留的独立风险因素.
- 为了评估与TAAD患者长期住院ICU相关的临床结果.
主要方法:
- 在2018年12月至2022年9月期间接受手术的100名TAAD患者的回顾性分析.
- 患者被分为常规 (<7天) 和长期 (≥7天) 的ICU停留组.
- 进行了单变量和逻辑回归分析,以确定独立的风险因素;两组之间的临床结果进行了比较.
主要成果:
- 延长ICU停留的独立风险因素包括紧急手术,手术前尿素的升高,以及更长的心肺绕道 (CPB) 时间.
- 这些因素的组合显示出显著的预测值 (AUC=0.810).
- 长时间在ICU住院的患者出现明显更高的不良事件率,包括肢体残疾,严重的器官损伤,气管切割和再输管.
结论:
- 紧急手术,手术前的尿素水平和CPB持续时间是TAAD修复后长时间的ICU停留的重要风险因素.
- 长时间的ICU停留与术后临床结果的恶化有关.
- 针对这些风险因素的积极战略对于减少ICU持续时间和改善患者结果至关重要.
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