患者因素,中心和时代对Fontan时间的影响:使用儿科健康信息系统数据库的观察性研究
Bethan A Lemley1, Oluwatimilehin Okunowo2, Steve B Ampah3
1Division of Cardiology, Lurie Children's Hospital and Department of Pediatrics, Feinberg School of Medicine Northwestern University, Chicago IL.
American heart journal
|February 27, 2024
概括
对于Fontan操作的最佳时间尚不清楚. 这项研究发现,中心之间的Fontan时间有显著的变化,随着时间的推移,Fontan的年龄总体增加.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 遗传性心脏病是一种先天性心脏病.
- 外科手术的结果
背景情况:
- 芬坦手术是单心室心脏病的关键阶段性缓解.
- 目前的指导方针在这个复杂的程序的最佳时间上缺乏共识.
研究的目的:
- 为了研究患者层面的因素,中心变化和时间趋势,这些因素影响了Fontan手术的时间.
- 识别与早期或后期的Fontan程序相关的特征.
主要方法:
- 在2007年至2021年期间,使用儿科健康信息系统数据库对10305名接受Fontan治疗的患者进行了回顾性分析.
- 采用线性混合效应建模,根据患者和中心特征以及运营年份,分析Fontan的年龄.
主要成果:
- 在Fontan的中位年龄为3.4岁. 低塑性左心综合征和并发症与年轻年龄有关,而技术依赖与年长年龄有关.
- 观察到种族差异,黑人和亚洲患者在更年长的年龄接受Fontan. 发现了显著的中心间时间变化,占变化率的10%.
- 随着时间的推移,Fontan的年龄增加了,每5年有0.61个月的老龄化趋势.
结论:
- 即使考虑到患者层面的因素,Fontan时间的显著中心间变化仍然存在.
- 患者接受Fontan手术的年龄一直在增加.
- 进一步的研究是必不可少的,以建立基于证据的指导方针,以实现最佳的Fontan运行时间.
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