年龄和肥胖对心脏移植结果的影响
Zach Rollins1, Ye In Christopher Kwon1, Graham Gardner1
1Division of Cardiothoracic Surgery, Department of Surgery, Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, Va.
JTCVS open
|July 9, 2025
概括
患有肥胖症 (高风险BMI) 或年龄较大 (高风险年龄) 的心脏移植接受者面临更糟糕的生存率. 患有这两种危险因素的患者的结果最差,但5年生存率仍然显著.
科学领域:
- 心脏病学 心脏病学
- 移植医学 移植医学
- 老年医学 老年医学
背景情况:
- 肥胖和老年是已知的风险因素,影响心脏移植患者的长期预后.
- 了解高风险患者群体的结果对于优化移植后护理至关重要.
研究的目的:
- 评估与正常风险接受者相比,心脏移植患者的5年生存率,高风险体重指数 (BMI>30),高风险年龄 (>70岁) 或两者兼而有之.
- 分析肥胖和老年结合对现代心脏移植结果的影响.
主要方法:
- 2014-2023年美国成年人心脏移植数据的分析.
- 卡普兰-梅尔生存曲线和日志等级测试用于比较正常风险和高风险组 (高风险BMI,高风险年龄或两者) 之间的生存率.
- 经风险调整的考克斯回归以确定影响整体存活率的因素.
主要成果:
- 总共分析了15839名正常风险,869名高风险年龄,8187名高风险BMI和202名高风险两组患者.
- 在各组中观察到总生存率的显著差异 (P < .001),高风险类别的生存率更差.
- 死亡风险比率为1.21 (高风险BMI),1.23 (高风险年龄) 和1.72 (两种高风险). 两种高风险患者的5年生存率为66.8%.
结论:
- 与正常风险患者相比,患有高风险BMI,高风险年龄或两者的心脏移植受体的整体存活率降低.
- 孤立的高风险BMI或高风险年龄具有类似的生存影响,而结合的因素导致了最糟糕的结果.
- 尽管风险增加,5年生存率,即使在高风险组合,强调心脏移植的持续益处.
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