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等候名单重量变化对心脏移植接受者的结果的影响:UNOS数据库分析
Melissa A Austin1, Danial Ahmad1, Jake L Rosen1
1Division of Cardiac Surgery, Thomas Jefferson University, 1025 Walnut Street, College Building, Suite 607, Philadelphia, PA, 19107, USA.
General thoracic and cardiovascular surgery
|October 3, 2024
概括
心脏移植前的体重变化 (HTx) 显著影响存活率. 体重减轻通常会使结果恶化,而适度的体重增加可能会使非肥胖患者受益,但卡塞克斯患者需要增加体重才能更好地生存.
科学领域:
- 心脏病学 心脏病学
- 移植医学 移植医学
- 医学研究 医学研究
背景情况:
- 关于心脏移植 (HTx) 之前动态体重变化的影响的数据有限.
- 之前的研究集中在移植前的体重,而不是等候名单期间的体重波动.
研究的目的:
- 为了研究心脏移植 (HTx) 清单体重和等候名单期间体重变化对心脏移植后生存的综合影响.
- 分析HTx后体重变化和生存结果之间的连续关系.
主要方法:
- 利用UNOS数据库确定1987年至2020年间HTx上市的成年患者.
- 采用3D限制立方线分析和Cox比例危险模型来评估与BMI/体重变化相对的生存率,并列出BMI.
- 分析了移植后生存的连续预测变量.
主要成果:
- 共有9628名患者接受HTx治疗,53%的患者体重减轻,47%的患者体重增加等待列表.
- 超过3个BMI点或10公斤的体重减轻与死亡风险增加有关,无论BMI是否列出.
- 非肥胖患者在适度体重增加 (1-4个BMI点或5-15公斤) 后的生存率有所改善,而如果体重没有增加,那么缓解体重的患者 (BMI<18.5) 的生存率会更差.
结论:
- 体重变化对心脏移植 (HTx) 结果的影响取决于患者最初的身体质量指数 (BMI).
- 在HTx之前显著减肥与较差的生存率有关,而一些体重增加可以使非肥胖的接受者受益.
- 应根据BMI列表量身定制体重管理策略,以优化移植后的生存率.
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