肺移植后早期气管切除术的影响:全国性分析
Nicole Charland1, Nikhil Chervu2, Saad Mallick3
1Cardiovascular Outcomes Research Laboratories (CORELAB), University of California, Los Angeles, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
肺移植患者的早期气管切除术可能会降低死亡率和感染率. 这种在术后8天前进行的手术与更短的住院时间和更低的成本有关,支持其安全性和益处.
科学领域:
- 医学研究 医学研究
- 移植手术 移植手术 移植手术
- 关键护理医学 关键护理医学
背景情况:
- 长时间的机械通风影响了近三分之一的肺移植接受者.
- 气管切除术是对内内管管道输入有益的替代方案,但安置往往会延迟.
- 没有大规模的研究检查了气管切除术时间对移植后结果的影响.
研究的目的:
- 调查早期气管切除术时间对成年肺移植接受者的移植后结果的影响.
- 评估早期气管切除术与住院死亡率,并发症和资源利用之间的关联.
主要方法:
- 对2016-2020年全国再接收数据库的分析,用于需要气管切除术的成年肺移植接受者.
- 早期气管切除术的定义是术后8天之前的放置.
- 利用多变量回归和平衡来进行风险调整.
主要成果:
- 早期气管切除术 (在第8天之前) 与死亡率降低 (AOR0.59) 和移植后感染 (AOR0.54) 相关.
- 移植后1周内进行气管切除术与停留时间 (-16.5天) 和住院费用 (-97,600美元) 的减少有关.
- 超过50%的需要气管切除术的患者接受了早期安置.
结论:
- 早期气管切除术对于精选的肺移植接受者来说是安全的,并且可能有益的.
- 在术后第8天之前安置可能会导致更早的出院,降低成本和更低的感染率.
- 研究结果支持早期气管切除术作为改善肺移植结果的策略.
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