手术前的中风预测了左侧感染性内心炎手术的患者的新术后临床意义上的中风
Nithya D Rajeev1, Markian M Bojko1, Jessica S Clothier1
1Division of Cardiac Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, Calif.
JTCVS open
|May 1, 2025
概括
在患有左侧传染性内心炎的患者中,术前中风增加了术后临床中风和功能衰竭的风险. 这些患者可能需要加强手术前评估和更高水平的退院后护理.
科学领域:
- 心血管外科心血管外科
- 神经外科 神经外科
- 传染性疾病 传染性疾病
背景情况:
- 左侧传染性内心炎 (LSIE) 与手术前中风 (PREOS) 的手术时间正在讨论中.
- 目前的指导方针依赖于术后放射性确认性中风 (RCS).
- 本研究评估了PREOS对手术结果的影响.
研究的目的:
- 评估手术前中风对LSIE患者手术结果的影响.
- 在这个人群中确定术后临床中风 (PCS),RCS和死亡率的风险因素.
主要方法:
- 在15年内对331名为LSIE进行了膜手术的患者进行了回顾性分析.
- 用PREOS和没有PREOS的队列的比较 (n=71与n=260).
- 倾向性得分匹配和后勤回归分析以确定风险因素.
主要成果:
- PREOS是PCS (OR,8.76;P <.001) 和新的功能衰竭 (P = .006) 的重要危险因素.
- 患有PREOS的患者的PCS,重复头部成像,功能衰竭和非家庭出院率较高.
- 术内,心脏性休克和三管手术是RCS的危险因素;PREOS,手术前功能衰竭,免疫抑制,三管吐和大动脉门手术是死亡的危险因素.
结论:
- 在接受手术的LSIE患者中,手术前的中风是PCS和新功能衰竭的重要危险因素.
- 患有PREOS的患者可能需要更密集的手术前评估和更高的退院后护理水平.
- 进一步的研究可能会完善PREOS的LSIE患者的操作时间指南.
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