需要重新手术的开放心脏手术的患者的死亡风险
Hannah Calvelli1, Mohammed Abul Kashem2, Katherine Hanna1
1Lewis Katz School of Medicine at Temple University, Philadelphia, PA.
Surgery
|October 18, 2024
概括
重复的开放心脏手术是复杂的. 随着每次后续手术的生存率都在下降,特别是对于门手术,体外膜氧化和多次重复手术.
科学领域:
- 心胸外科手术是一项心胸手术.
- 心脏外科手术的结果
- 患者生存分析分析.
背景情况:
- 手术技术和术后护理的进步使复杂的再手术开放心脏手术成为可能.
- 患者预期寿命的增加导致越来越多的患者需要重复心脏手术.
- 确定适合于重复手术心脏手术的候选人仍然是一个临床挑战.
研究的目的:
- 评估接受重复手术开放心脏手术的患者的生存结果.
- 为了比较不同年龄组 (<65 vs. ≥65岁) 在重复手术心脏手术中的存活率.
- 在接受重复开放心脏手术的患者中确定与生存相关的因素.
主要方法:
- 在2012-2022年期间,对250名接受重复手术开放心脏手术的患者进行了回顾性单中心研究.
- 排除之前使用心室辅助器件或心脏移植的患者.
- 使用卡普兰-梅尔曲线,日志等级测试和Cox比例危险回归的生存分析,按年龄分层.
主要成果:
- 整体30天死亡率为13.6%,一年死亡率为21.2%.
- 65岁以上的患者的平均存活时间 (5.0年) 与65岁以下的患者 (4.1年,P=.046) 相比,平均存活时间更长.
- 多变量分析表明,重复手术的门手术,手术期间的体外膜氧化,以及更多的重复手术与较低的存活率有关.
结论:
- 重复手术的开放心脏手术患者在临床上是复杂的.
- 随着每次后续的重新手术,生存率都在下降.
- 年龄在冠状动脉绕道移植或门手术等特定程序分层时没有显著影响生存率.
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