超多药性是左心室辅助器件 (LVAD) 植入后死亡率的预测因素
Lauren Dautzenberg1, Lieke Numan2, Wilma Knol1
1Department of Geriatric Medicine, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands.
概括
超多药性,定义为10种或更多种药物,在左心室辅助器件 (LVAD) 患者中很常见. 这种高药物负担与增加的死亡风险有关,突出显示在LVAD护理中需要药物管理策略.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学 是一个学科.
- 医疗器械 医疗器械
背景情况:
- 左心室辅助器件 (LVAD) 的患者中多药物的患病率和影响尚不清楚.
- 研究多药学对于优化这种脆弱患者群体的临床结果至关重要.
研究的目的:
- 为了确定LVAD患者在出院时的多药和高多药的患病率.
- 评估超多药和不良临床结果之间的关联,包括死亡率和并发症.
主要方法:
- 分析了一组210名40岁及以上的患者,他们在2011年至2019年期间接受了初级LVAD植入物.
- 多药性 (5-9种药物) 和高多药性 (≥10种药物) 在出院时被定义.
- 考克斯回归模型评估了≥10种药物与死亡率,心律失常,驱动线感染和严重出血的相关性.
主要成果:
- 平均排放药物的数量为8.8 ± 2.3.3.
- 多药性 (5-9药) 和高多药性 (≥10药) 分别在62.9%和34.8%的患者中流行.
- 处方≥10种药物独立地与2.03倍的死亡风险增加有关 (aHR为2.03;95% CI为1.15-3.6;p=0.02),但没有严重的出血,心律失常或驱动线感染.
结论:
- 超多药性在LVAD患者中非常普遍,是增加死亡率的独立预测因素.
- 进一步的研究应集中在药物的风险益处分析上,以优化多药性和减少LVAD接受者的不良事件.
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