脏移植受体的脆弱性和移植后不良结果 系统性审查和元分析
Yanqiu Wang1, Jingli Kou1, Ludan Xu2
1Department of Geriatrics, Xuan Wu Hospital Capital Medical University, Beijing, China.
概括
脆弱性显著增加了移植患者的不良结果,包括死亡率和移植失败. 在移植之前评估脆弱性对于改善患者管理和结果至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 老年病的医生 老年病的医生
- 移植医学 移植医学
背景情况:
- 虚弱是老年手术患者不良结果的重要预测因素.
- 与普通人群相比,移植候选人的脆弱性患病率更高.
- 了解移植后的脆弱性影响对于患者护理至关重要.
研究的目的:
- 系统地审查和元分析性对移植后不良结果的预测价值.
- 巩固关于虚弱与移植后并发症和生存相关的证据.
主要方法:
- 使用Embase,Medline,Cochrane和PsycINFO数据库进行了前性研究的系统审查.
- 用随机效应元分析 (RevMan 5.3) 合成了数据,用于到2022年5月20日发表的研究.
- 包括14项研究,其中8项适合进行定量元分析.
主要成果:
- 脆弱性与增加的死亡率 (HR 1.98) 和死亡审查的移植失败 (HR 3.31) 有关.
- 虚弱的接受者面临更高的手术并发症风险 (RR 2.14) 和长时间住院 (RR 1.59,或1.72 ≥2周).
- 审查发现了脆弱性和各种移植后不良事件之间的显著关联.
结论:
- 脆弱性被证明与移植后的不良结果有关.
- 建议对脏移植候选人进行移植前的脆弱性评估.
- 需要进一步的研究,整合移植前的脆弱性评估,以优化移植管理.
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