在接受门置换手术的老年患者中早期急性损伤恢复
Ying-Wen Lin1, Qi Wang2, Pei-Shan Lu3
1Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
Journal of cardiothoracic and vascular anesthesia
|July 17, 2024
概括
在门置换手术 (VRS) 后的急性损伤 (AKI) 在48小时内迅速恢复,不会带来额外的风险. 然而,持续持续超过48小时的AKI显著增加了不良事件和死亡风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心血管外科心血管外科
- 关键护理医学 关键护理医学
背景情况:
- 急性损伤 (AKI) 是置换手术 (VRS) 后的一种严重并发症.
- 了解AKI恢复模式对于患者的治疗结果至关重要.
- 不同的AKI恢复轨迹后VRS的预后影响仍然不完全定义.
研究的目的:
- 为了确定急性损伤 (AKI) 恢复模式的发生率,在门置换手术 (VRS) 后的患者.
- 确定与持续性AKI相关的促成因素.
- 评估各种AKI恢复模式对临床结果的预后影响.
主要方法:
- 追溯队列研究涉及4161名患者,他们在2010年至2019年期间接受了VRS.
- 患者被分为非AKI,早期康复的AKI (<48小时) 和持久的AKI组.
- 评估的结果包括住院重大不良临床事件,住院死亡率和1年死亡率.
主要成果:
- 36.4%的人没有AKI,45.1%的人经历了早期AKI恢复,18.6%的人患有持续的AKI.
- 持续性AKI的独立风险因素包括晚年,糖尿病,心力衰竭,功能障碍,贫血和AKI2-3阶段.
- 持续性AKI与更高的住院不良事件 (20.6%与4.7%的早期恢复相比,与3.9%的非AKI相比) 和死亡率的增加有关.
结论:
- 与非AKI相比,VRS后AKI (<48小时) 的早期恢复与不良结果的增加无关.
- 在VRS之后持续的AKI (持续时间>48小时) 是更糟糕的住院和长期结果的独立预测因素.
- 基于AKI恢复模式的风险分层可以为VRS后的临床管理和预后提供信息.
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