一个简单的单项护理布评估预测了D期心力衰竭患者接受手术先进疗法的结果
Vincent D Salvador1, Jaime Abraham Perez2, Paige W Hudec1
1University Hospitals Harrington Heart & Vascular Institute, Cleveland, Ohio, USA.
Clinical transplantation
|April 14, 2025
概括
在接受心脏移植或LVAD植入的高级心力衰竭患者中,病史中的跌倒表明手术后的结果更差,包括更长的住院时间和对置换治疗的需求增加.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 移植手术 移植手术
背景情况:
- 虚弱与接受手术治疗的晚期心力衰竭 (HF) 患者的不良结果有关.
- 跌倒是脆弱的常见表现,但它们对术后风险的预测价值尚不清楚.
- 这项研究调查了下跌史是否预测了高级HF疗法后的不良结果.
研究的目的:
- 要确定通过简单的查发现的跌倒病史是否与接受正心移植 (OHT) 或左心室辅助器件 (LVAD) 植入的患者的术后结果更差有关.
- 评估手术前跌倒对停留时间,机械通风持续时间,置换疗法 (RRT) 使用和存活率的影响.
主要方法:
- 在2020年至2023年期间接受OHT或LVAD植入的患者的回顾性分析.
- 主要暴露:在手术前12个月内通过护理问卷评估的跌倒史.
- 追踪的结果:住院和ICU停留时间,机械呼吸器使用,RRT和生存率.
主要成果:
- 跌倒史与显著延长的机械支 (+1.5天),ICU停留 (+13天) 和整体住院 (+17天) 相相关.
- 患有跌倒病史的患者在手术后90天内需要RRT的可能性更高 (调整HR:4.7).
- 没有观察到有史以来跌倒和没有跌倒的患者之间的生存率有显著差异.
结论:
- 一个简单的,单项的护理跌倒评估有效地识别了经过OHT或LVAD后患有不良术后结果风险较高的晚期心力衰竭患者.
- 手术前的查可以帮助在接受重大心脏手术的晚期心力衰竭患者的风险分层.
- 早期识别跌倒风险可能允许针对性的干预措施,以改善这一脆弱患者群体的结果.
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