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中度和重度的慢性病预测在主要的下肢截肢之后,在5年内死亡率更高
Luke T Pitsenbarger1, Maria N Som1, Natalie T Chao1
1Department of Surgery, Vascular Division, University of Maryland School of Medicine, Baltimore, MD, USA.
Annals of vascular surgery
|April 10, 2024
概括
患有慢性病 (CKD) 的患者在重大下肢截肢 (LEA) 后面临更高的死亡率. 即使是轻微的CKD也会增加长期存活风险,这凸显了手术前功能评估的必要性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 血管外科 血管外科
- 研究成果 研究成果 研究成果
背景情况:
- 严重的慢性病 (CKD) 是已知的下肢截肢 (LEA) 后死亡率的预测因素.
- 早期CKD对LEA后死亡率的影响尚不清楚.
- 了解这些风险对于患者管理和手术决策至关重要.
研究的目的:
- 为了调查慢性病 (CKD) 和严重下肢截肢 (LEA) 后的长期死亡率之间的联系.
- 为了确定CKD不同阶段是否影响术后生存率.
- 确定潜在的风险因素,并为接受LEA.患者的临床实践提供信息.
主要方法:
- 在2015年至2021年期间,对565名患者进行了无创性主要LEA的回顾性图表审查.
- 患者根据功能 (CKD阶段) 进行了分层.
- 使用卡普兰-梅尔和考克斯回归分析,比较了包括生存在内的长期术后结果.
主要成果:
- 手术前的CKD与患者特征,并发症,随访时间缩短和存活率降低有关.
- 与没有CKD的患者相比,轻度,中度或重度CKD的患者在LEA后的5年生存率明显较差 (P<0.001).
- 严重的CKD独立预测1年 (OR 2.91) 和5年 (OR 3.08) 死亡率更差;中度的CKD预测5年死亡率更差 (OR 2.66).
结论:
- 中度和严重的CKD独立地预测大LEA后的长期死亡率增加.
- 这些发现表明了潜在的因果关系,并强调了早期CKD识别和手术前优化的重要性.
- 改善经过LEA的CKD患者的手术前评估和管理可能会改善长期结果.
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