超越咨询:儿童VAD转诊后的结果
Shannon Oliver1, Asseel Alsalmi1, Tara Pidborochynski1
1Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
JHLT open
|July 21, 2025
概括
三分之一被转诊接受心室辅助器械 (VAD) 治疗的患者是急性转诊患者,面临更高的一年死亡率. 双胞胎先天性心脏病和缺乏并发症独立预测急性转诊状态.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 机械循环支持 机械循环支持
背景情况:
- 对于未植入心室辅助器件 (VAD) 治疗而被转诊但未植入患者的结果的理解有限.
- 专注于描述这个特定的患者群体的初始咨询后的一年结果.
研究的目的:
- 为了描述最终没有植入VAD治疗的转诊患者的结果.
- 为了确定与急性转诊状态与选择性转诊相关的因素.
主要方法:
- 从2019年1月1日到2023年12月12日,对128名被转介到VAD服务的患者进行了回顾性分析.
- 在30天和1年的咨询后评估结果.
- 多变量逻辑回归确定了急性转诊的风险因素 (定义为30天内死亡,VAD不适合或ECMO).
主要成果:
- 31%的转诊在30天内被归类为急性.
- 与选择性转诊相比,急性转诊患者的1年生存率明显较差 (p < 0.001).
- 急性转诊的独立风险因素包括双心室先天性心脏病 (CHD),其他非CHD/心肌病诊断,以及缺乏并发症.
结论:
- 大约三分之一的VAD转诊是急性,与1年死亡率的增加有关.
- 双性心脏病和缺乏并发症是急性转诊的关键预测因素.
- 早期识别急性转诊风险因素对于及时干预至关重要.
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