患有活跃血性恶性瘤的患者心脏性休克:一个多中心回顾性研究
Mickael Lescroart1, Hélène Kemp2, Olivier Imauven3
1Hospital Saint-Louis et Université Paris Cité, Assistance Publique-Hôpitaux de Paris, France; CHRU de Nancy, Médecine Intensive et Réanimation Brabois, Université de Lorraine, Vandœuvre-Lès-Nancy, France.
Journal of critical care
|January 23, 2025
概括
在ICU中患有心脏性休克的瘤血液病患者的预后不好. 上腺素使用与更糟糕的结果有关,强调需要更好的风险评估和治疗方法.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 密集护理医学 密集护理医学
背景情况:
- 瘤血液学 (OH) 患者经历恶性瘤和治疗的心血管风险增加.
- 有限的数据存在心脏性休克 (CS) 特性和结果在OH患者在重症监护室 (ICU).
研究的目的:
- 为了确定患有CS的OH患者30天死亡率的风险因素.
- 描述这个患者群体的早期和长期结果.
- 为了评估恶性瘤的预后影响OH患者与CS.
主要方法:
- 一项多中心的回顾性研究,从2010年至2021年,在22个重症监护室 (ICU) 参与了214名患有CS的OH患者.
- 多变量分析以确定死亡风险因素.
- 与对照组进行比较,以评估恶性瘤的预后影响.
主要成果:
- 30天的存活率为44.8%.
- 造成30天死亡的危险因素包括先前的心肌病,急性损伤,乳酸水平升高,肺栓塞,机械通风和上腺素使用.
- 高血压恶性瘤与30天死亡率的增加显著相关 (HR 2.54).
结论:
- 在ICU中患有CS的OH患者的预后不好.
- 上腺素的使用与更糟糕的结果有关.
- 需要进一步的研究,以改善风险分层和治疗策略.
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