预防干预 乌干达风湿性心脏病患者的等待时间和生存率
Chang Yoon Doh1, Crystal An1, Andrew Y Chang2
1School of Medicine, Case Western Reserve University, Cleveland, Ohio.
The Annals of thoracic surgery
|June 22, 2024
概括
乌干达的风湿性心脏病 (RHD) 患者在手术前面临长时间的等待和高死亡率. 年龄,性别和教育等因素阻碍了获得必不可少的RHD手术护理.
科学领域:
- 心脏病学 心脏病学
- 全球健康 全球健康
- 外科手术的结果
背景情况:
- 乌干达的风湿性心脏病 (RHD) 患者的手术负担很大.
- 在RHD中延迟手术干预和手术前死亡率的风险因素尚不清楚.
研究的目的:
- 调查第一次手术干预的时间,并确定乌干达RHD患者手术前死亡率的预测因素.
主要方法:
- 利用乌干达国家RHD注册表 (2010-2022) 的数据.
- 使用卡普兰-梅尔估计和多变量考克斯比例危险模型来分析结果.
主要成果:
- 64%的RHD患者符合手术的标准,但只有13.5%接受了手术;30.6%在手术前死亡.
- 第一次手术的中位时间显著延迟,50%的概率为9.3年.
- 诸如男性性别,高等教育和心房等因素增加了干预的可能性,而年轻的年龄和严重的功能类别降低了干预的可能性.
- 术前死亡率与传染性内心炎,心室功能障碍,心周溢血,心房动和多个门指示有关.
结论:
- 长期推迟手术干预和高的手术前死亡率是乌干达RHD护理的特点.
- 年龄,性别和教育水平对获得必要的RHD手术存在重大障碍.
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