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在接受过导管大动脉置换的老年人中,诱导后低血压和不良结果:回顾性队列研究
Ting-Ting Ni1, Yuan-Yuan Yao1, Xiao-Xia Zhou1
1Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, 330100, People's Republic of China.
Clinical interventions in aging
|November 26, 2024
概括
诱导后低血压 (PIH) 增加了跨导管大动脉置换 (TAVR) 患者不良事件的风险. 这包括中风和急性损伤 (AKI) 的更高率.
科学领域:
- 心脏病学 心脏病学
- 麻醉学 麻醉学
- 老年病的医生 老年病的医生
背景情况:
- 诱导后低血压 (PIH) 在接受过导管大动脉置换 (TAVR) 的老年人中是一个关键问题.
- 在TAVR患者中,与年龄有关的心血管变化和并发症加剧了与PIH相关的风险.
研究的目的:
- 研究TAVR患者的诱导后低血压和术后不良事件之间的关联.
- 评估不同平均动脉压 (MAP) 值对不良结果的影响.
主要方法:
- 777名TAVR患者的回顾性分析.
- 定义了绝对MAP值 (<65,<60 mmHg) 和相对值 (>20%,>30%比基线下降).
- 倾向性得分匹配和治疗权重的逆概率被用来分析结果.
主要成果:
- PIH与住院死亡率,中风,急性损伤 (AKI) 和心肌梗塞 (MI) 的综合结果有显著联系.
- 在PIH患者中观察到复合结局的更高发病率 (RR:MAP<60 mmHg的RR:2.47).
- 在MAP<60 mmHg时,PIH与中风风险增加密切相关 (RR:5.22) 和AKI (RR:2.82).
结论:
- 诱导后低血压显著增加了TAVR患者复合不良结果的风险.
- 在PIH的存在下,中风和AKI的特定风险显著增加.
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