术前COVID-19疫苗接种与重大血管手术后的术后死亡率降低有关
Molly Ratner1, Karan Garg1, Heepeel Chang2
1Division of Vascular and Endovascular Surgery, Department of Surgery, New York University Langone Medical Center, New York, NY.
Annals of surgery
|May 10, 2024
概括
接种COVID-19疫苗显著降低了接受大血管手术的患者的30天死亡率. 这种保护作用在诸如大动脉动脉瘤修复和下内绕道等手术中尤为明显.
科学领域:
- 血管外科 血管外科
- 传染病流行病学 传染病流行病学
- 公共卫生 公共卫生
背景情况:
- 接种COVID-19疫苗与一般手术患者的死亡率降低有关.
- 大型血管手术后COVID-19疫苗接种对术后死亡率的具体影响仍未得到充分研究.
研究的目的:
- 为了调查COVID-19疫苗接种和经历大血管手术的患者的外科治疗后结果之间的关联.
- 确定疫苗接种状态是否影响该患者队列的30天死亡率.
主要方法:
- 一个多中心的回顾性研究设计.
- 包括2021年12月至2023年8月接受了主要血管手术的85,424名患者.
- 用多变量模型对30天内所有原因死亡率进行分析,以调整风险因素.
主要成果:
- 疫苗接种与风险因素调整后30天死亡率 (OR 0.7,P <0.0001) 的统计学显著降低有关.
- 在特定的手术中观察到较低的死亡率:开放AAA (OR 0.6),EVAR (OR 0.6),CAS (OR 0.7) 和下内绕道 (OR 0.7).
- 与接种疫苗的人相比,未接种疫苗的患者更年轻,并患上较少的并发病.
结论:
- 在接受重大血管手术的患者中,COVID-19疫苗接种与术后死亡率降低有关.
- 接种疫苗的好处最明显的是对大动脉动脉瘤修复,带支架和下内绕道手术的好处.
- 在主要血管干预的背景下,疫苗接种似乎是预防死亡的保护因素.
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