住院时间对心脏病发作相关心脏性休克的预后影响:一个ECLS-SHOCK子研究
Tobias Schupp1, Holger Thiele2, Tienush Rassaf3
1Department of Cardiology, Angiology, Hemostaseology and Medical Intensive Care, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
JACC. Cardiovascular interventions
|October 17, 2024
概括
入院时间没有影响与心脏性休克 (AMI-CS) 相关的急性心肌梗塞的结果. 身体外生命支持 (ECLS) 显示出类似的疗效,不管是上班时间还是下班时间入院,30天死亡率没有显著差异.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 医疗技术 医疗技术 医学技术
背景情况:
- 急性心肌梗塞与心脏性休克 (AMI-CS) 的结果可能会受到入院时间的影响.
- 在AMI-CS患者体外生命支持 (ECLS) 的疗效和安全性也可能因入院时间而异.
研究的目的:
- 调查AMI-CS.患者在工作时间内与工作时间外入院的预后影响.
- 根据该患者队列的住院时间来评估ECLS的疗效.
主要方法:
- 多中心,随机ECLS-SHOCK试验 (2019-2022) 的一个子研究包括AMI-CS.患者.
- 患者被分为在上班时间和下班时间的入院组.
- 主要终点是30天全因死亡率,使用Kaplan-Meier和后勤回归分析.
主要成果:
- 与工作时间内入院相比,非工作时间内入院 (48.4%) 与30天死亡率的增加无关 (OR:0.83;95%CI:0.56-1.22).
- 对于上班时间 (OR:0.98;95% CI:0.58-1.68) 或下班时间 (OR:0.94;95% CI:0.54-1.63) 的入院,ECLS对30天死亡率没有显著的预后影响.
- ECLS与更高的出血事件风险有关,特别是在上班时间入院的患者中.
结论:
- 住院时间似乎不会影响AMI-CS.患者的预后.
- 在AMI-CS患者中,ECLS的治疗效果在工作时间内和工作时间外的入院均一致.
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