在A型大动脉剖析手术后的手术死亡率:基于性别和年龄的差异
Hong Liu1, Hai-Yang Li2,3, Yi-Lin Li2,3
1Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
JACC. Advances
|June 28, 2024
概括
急性甲型大动脉解剖 (ATAAD) 死亡率的性别差异存在争议. 这项研究发现,老年女性 (55岁以上) 的手术后死亡率高于男性,而年轻女性的风险相似.
科学领域:
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
- 主动脉疾病 主动脉疾病
背景情况:
- 在急性A型大动脉剖析 (ATAAD) 后的短期死亡率中存在性别差异的争议.
- 了解这些差异对于优化ATAAD患者手术结果至关重要.
研究的目的:
- 调查性别对手术治疗的ATAAD患者30天后死亡率的影响.
- 为了确定年龄是否改变了ATAAD中性别和手术死亡率之间的关联.
主要方法:
- 从多中心中国5A研究中分析了5670名经过手术修复的ATAAD患者.
- 手术死亡率是主要结果,与年龄相关的趋势是使用立方线模拟的.
- 倾向性评分分析被用来调整潜在的混因素.
主要成果:
- 女性 (26.5%) 年龄较大,并比男性 (73.5%) 有较少的并发症.
- 未调整的死亡率在女性 (10.2%) 和男性 (8.2%,P=0.019) 中较高,但在倾向性分析后并不显著.
- 观察到性别和年龄之间的显著相互作用 (P=0.035):年龄较大对女性的死亡风险比男性的死亡风险更大.
- 死亡风险在55岁时有所不同;55岁以下的女性与男性的几率相似,而55岁以上的女性的几率更高 (OR: 1.420).
结论:
- 55岁以下的女性ATAAD患者与男性相比,手术后死亡率的几率相似.
- 55岁以上的女性ATAAD患者面临的手术后死亡率明显高于男性.
- 考虑到年龄和性别的个性化风险评估对于在ATAAD中定制治疗策略至关重要.
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