心脏手术后早期术后科佩的预测价值:一项两中心前性队列研究
Anna Kirkopoulos1, Irsa Salehi, René M'Pembele
1From the Department of Anesthesiology, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany (AK, RM, PM, AS, TT, DD, RH, DK-M, GLB, SR), Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany (IS, AH, JB, SD, TB, MMB), Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Medicine, RKH Hospital Ludwigsburg, Ludwigsburg, Germany (MMB), Department of Anesthesiology, Kerckhoff Klinik, Bad Nauheim, Germany (RH).
心脏外科手术后高水平的可佩与一年后出现新发性残疾的风险更高有关. 然而,由于其预测能力较弱,不建议定期测量可佩丁.
科学领域:
- 心脏病学和重症监护医学
- 在术后结果中的生物标志物研究.
背景情况:
- 心脏手术患者面临着术后并发症的重大风险,需要早期风险评估.
- 作为一种神经性标记物,可佩在非心脏手术中具有预测不良事件的潜力,但其在心脏手术中的作用尚未得到充分探索.
研究的目的:
- 为了研究早期术后的可佩水平与心脏手术后的不良事件之间的关联.
- 评估copeptin在预测心脏手术后一年新发性残疾方面的实用性.
主要方法:
- 一项观察性前性队列研究,涉及接受选择性抽动心脏手术的成年患者.
- 测量早期手术后的可佩素水平.
- 评估的主要结局是使用WHODAS 2.0评分在1年内出现新发性残疾.
主要成果:
- 提升的早期术后可佩水平独立地与一年后出现新发残疾的可能性更高有关 (aOR 2.35).
- 该研究包括295名患者,其中18.3%的患者经历了新发性残疾和3.4%的死亡率在一年内.
- 科佩对新发性残疾的歧视很弱,并且在与EuroSCORE II等既定得分相结合时,并没有显著改善风险分层.
结论:
- 早期术后的可佩是心脏手术后长期残疾的独立预测剂.
- 由于其预测性表现有限,不建议在风险分层方面进行常规测量可佩丁.
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