在大量人群中出现不良结果的危险因素
Giancarlo Licitra1, Lindsey C Ivey2, Cheryl L Raskind-Hood2
1Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA, USA. giancarlo.licitra@emory.edu.
Pediatric cardiology
|June 6, 2025
概括
晚期芬坦失败是很常见的. 并发症随着年龄的增长而增加,在儿童和成人患者中显著增加心脏移植,癌症,死亡和住院的风险. 早期干预是关键的.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 成年人的先天性心脏病
背景情况:
- 改善的Fontan手术生存率受到Fontan晚期失败的挑战.
- 晚期失败源于异质的,多器官并发症,随着时间的推移而演变.
研究的目的:
- 为了评估与Fontan相关的并发症的流行率.
- 评估这些并发症与儿科和成人Fontan患者的不良结果之间的关联.
主要方法:
- 分析了668名儿科和成人Fontan患者的队列,使用医疗保健遭遇和死亡证明数据 (2010-2019).
- 双变量分析确定了复合结局 (心脏移植,肝细胞癌[HCC]或死亡) 的风险因素.
- 多变量逻辑回归和卡普兰-梅尔曲线评估了风险因素关联和生存结果.
主要成果:
- 12.3%的患者经历了复合结局,成人 (21.3%) 的发病率高于儿童 (9.0%).
- 临床风险因素随着年龄的增长而增加,并与HCC相关. 患有3+危险因子的患者的存活率明显降低 (逻辑等级p<0.01).
- 心力衰竭是最强的预测因素 (aOR 5.90);3个+风险因素使复合结果增加了4倍 (aOR 3.71),影响了儿童和成人.
结论:
- 与Fontan相关的并发症随着患者年龄的增加而增加,并与移植,HCC,死亡和住院有关.
- 这些发现凸显了早期发现并发症的必要性和对并发症的干预,以改善Fontan幸存者的长期结果.
相关概念视频
01:26Factors Affecting the Risk of Infection
13.8K
The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
13.8K
01:24Drug Toxicity: Risk factors
1
Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
1
02:04Conservation of Small Populations
17.4K
Small population sizes put a species at extreme risk of extinction due to a lack of variation, and a consequent decrease in adaptability. This weakens the chances of survival under pressures such as climate change, competition from other species, or new diseases. Large populations are more likely to survive pressures such as these, as such populations are more likely to harbor individuals that have genetic variants that are adaptive under new stresses. Small populations are much less...
17.4K
00:57Population Growth
28.7K
Population size is dynamic, increasing with birth rates and immigration, and decreasing with death rates and emigration. In ideal conditions with unlimited resources, populations can increase exponentially, which plots as a J-shaped growth rate curve of population size against time. This type of curve is characteristic of newly-introduced invasive species, or populations that have suffered catastrophic declines and are rebounding.
28.7K
01:25What is Population Genetics?
65.0K
A population is composed of members of the same species that simultaneously live and interact in the same area. When individuals in a population breed, they pass down their genes to their offspring. Many of these genes are polymorphic, meaning that they occur in multiple variants. Such variations of a gene are referred to as alleles. The collective set of all the alleles within a population is known as the gene pool.
65.0K
02:24Predicting Reaction Outcomes
11.0K
Kinetics describes the rate and path by which a reaction occurs. In contrast, thermodynamics deals with state functions and describes the properties, behavior, and components of a system. It is not concerned with the path taken by the process and cannot address the rate at which a reaction occurs. Although it does provide information about what can happen during a reaction process, it does not describe the detailed steps of what appears on an atomic or a molecular level. On the other hand,...
11.0K