评估皮肤冠状动脉干预过程中手术输管的可能性
Megan Herson1, Sean Tan1,2, Joseph O'Brien1,2
1Monash Heart Victorian Heart Hospital, Monash Health Melbourne Australia.
Journal of the American Heart Association
|January 16, 2025
概括
穿皮冠状动脉干预 (PCI) 过程中的手术输管很少见 (0.5%),但与较高的死亡率有关. 在PCI之前禁食可能不对所有患者来说都是必要的,可能会使高风险个人受益.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 患者安全 患者安全
背景情况:
- 在皮肤冠状动脉干预 (PCI) 之前,程序前的禁食是标准的.
- 在PCI过程中手术输管的发生率尚未得到充分证实.
- 这项研究调查了PCI期间输管的频率和预测因素.
研究的目的:
- 为了确定PCI过程中手术输管的发生率.
- 在接受PCI的患者中确定手术输管的预测因素.
- 评估手术输管与30天死亡率之间的关联.
主要方法:
- 在83,929名接受PCI治疗的患者 (2014-2021) 中进行了回顾性队列研究.
- 对PCI紧急情况的分类 (紧急,半紧急,可选).
- 使用了逆概率治疗权重和后勤回归分析.
主要成果:
- 过程性输管的发生率为0.5%.
- 紧急的PCI显著增加了输管风险 (OR, 19.68).
- 程序性输管与30天死亡率的增加有关 (OR,4.79).
- 预测因素包括心脏性休克,医院外心脏骤停,大腿部接触,左主病,C型病变和旋转性心脏切除术.
结论:
- 在PCI期间的手术输管是不常见的,但与更糟糕的结果有关.
- 普遍的程序前禁食可能是不必要的.
- 禁食协议可以根据高风险患者群体量身定制.
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