在手术前升高的VE/VCO2斜率和大手术后增加的死亡率之间存在关联:一项元分析
Xuming Yin1, Jiao Huang2, Yang Zhao3
1Department of Anesthesiology, Nanjiang People's Hospital, Nanjiang, Sichuan, China.
较高的手术前VE/VCO2斜率,衡量心肺功能,与大手术后成年人死亡风险增加有关. 这一发现突显了其作为外科手术结果预后指标的潜力.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 外科手术的结果
背景情况:
- 大型手术患者的二氧化碳 (VE / VCO2) 产量斜率的术前呼吸器等效的预后价值仍然不清楚.
- 了解术后死亡率的预测因素对于患者管理和风险分层至关重要.
研究的目的:
- 系统地评估手术前的VE/VCO2倾斜率与接受重大手术的成年人全因死亡率之间的关联.
- 综合观察性研究的证据,以确定手术结果的VE/VCO2斜率的预测准确性.
主要方法:
- 在PubMed和Embase数据库中进行了全面的文献搜索,截至2023年11月.
- 对14项涉及7637名患者的观察性研究的元分析使用随机效应模型进行.
- 主要结局是全因死亡率,分析了VE/VCO2斜率的连续和二分法尺度.
主要成果:
- 在连续尺度上,较高的手术前VE/VCO2斜率与死亡率的增加显著相关 (OR,1.11;95% CI,1.07-1.16).
- 升高的VE/VCO2斜率表明在二分法尺度上死亡风险更高 (OR,2.77;95%CI,1.89-4.06).
- 这种关联在不同类型的手术中保持一致,并预测了短期 (30/90天) 和长期 (1-5年) 的死亡率.
结论:
- 术前VE/VCO2斜率升高是成人大手术后短期和长期死亡率增加的重要预测因素.
- VE/VCO2斜率作为评估术后死亡风险的有价值的预后标记.
- 这些发现支持将VE/VCO2斜率评估纳入重大外科手术手术前评估.
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