使用修订的心脏风险指数评估非心脏手术后风险的性别差异 - 全国追溯队列研究
Tomohisa Seki1, Yoshimasa Kawazoe1,2, Toru Takiguchi1
1Department of Healthcare Information Management, The University of Tokyo Hospital.
概括
修订后的心脏风险指数 (RCRI) 有效地分层了非心脏手术后主要心血管不良事件的风险. 虽然在不同性别中普遍可靠,但RCRI为0的男性的风险略高,尽管这一发现需要进一步调查.
科学领域:
- 心脏病学 心脏病学
- 在外科手术期间的医学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 修订的心脏风险指数 (RCRI) 是手术前风险评估的标准工具.
- 对于RCRI,存在有限的大规模验证研究.
- 性别差异对RCRI表现的影响还不太清楚.
研究的目的:
- 用RCRI评估心血管风险分层中的性别差异.
- 评估RCRI在大量现实世界人口中的表现.
主要方法:
- 来自日本医学数据中心数据库 (2005-2021) 的161,359次非心脏手术的分析.
- 主要结局:主要心血管不良事件的30天风险.
- 基于RCRI得分和性别的风险分层.
主要成果:
- 在日本的真实世界数据中,RCRI证明了性别之间的合理风险分层.
- 具有0的RCRI的男性患术后事件的危险率显著更高 (HR 1.32).
- 在低风险组中,这种基于性别的差异在排除乳腺和妇科手术时并不显著.
结论:
- RCRI是进行手术前风险查的有效工具,无论性别如何,都能充分发挥作用.
- 需要进一步的研究,以充分阐明术后心血管风险的性别差异.
- 目前的数据支持继续使用RCRI用于查目的.
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