年龄并不是八十多岁的人经历复杂的内血管大动脉修复的结果的唯一预测因素
Tiam Feridooni1, Lauren Gordon1, Daniyal N Mahmood1
1Division of Vascular Surgery, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Journal of vascular surgery
|April 11, 2024
概括
经过化/分支的内血管动脉瘤修复 (F/BEVAR) 的八分生体患者的死亡率和不良事件率略高. 然而,年龄应该与其他因素一起考虑,而不是作为F/BEVAR的严格排除标准.
科学领域:
- 血管外科 血管外科
- 血管内主动脉修复 血管内主动脉修复
- 老年心脏病学 老年心脏病学
背景情况:
- 窗口/分支内血管动脉瘤修复 (F/BEVAR) 为复杂的大动脉动脉瘤提供了一个不那么侵入性的选择.
- 在老年人群中F/BEVAR的安全性和有效性,特别是八十岁以上 (≥80岁) 的人群中,需要进一步研究.
- 了解八十岁的结果对于在这个日益增长的人口中做出明智的治疗决策至关重要.
研究的目的:
- 为了比较F/BEVAR在八十岁人群与非八十岁人群的术前,术后和长期结果.
- 确定影响死亡率和F/BEVAR后不良事件的风险因素.
- 评估年龄作为F/BEVAR后结果的独立预测因素的作用.
主要方法:
- 一个多中心的,回顾性队列研究,利用血管质量改善数据库 (2012-2022).
- 包括接受F/BEVAR的6007名患者,分为80岁以下 (n=4860) 和80岁以上 (n=1147) 的两层.
- 术前,术后和术后因素的比较,主要结果是长期所有原因的死亡率.
主要成果:
- 在技术成功,LOS,ICU停留或缺血症并发症方面,两组之间没有显著差异.
- 八重生患者患术后并发症的可能性增加 (OR:1.16) 并被送往康复/护理机构.
- 八十岁以上的人的五年生存率较低 (71%vs. 83%),年龄被确定为所有原因 (HR: 1.72) 和主动脉特定死亡率 (HR: 1.92) 的重要预测因素.
结论:
- 在F/BEVAR后,八代人体验了轻微增加的死亡率和不良事件.
- 年龄,当调整其他风险因素时,与其他并发症相比,不应该成为严格的排除标准.
- 对F/BEVAR患者的选择应考虑对大动脉解剖,健康和功能状况的整体评估.
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