中心门手术的教科书结果-来自荷兰的心脏注册的结果
Kinsing Ko1,2, Samuel Heuts3,4, Andrew Tjon Joek Tjien5
1Department of Cardiothoracic Surgery, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
概括
在米特拉手术中,教科书结局 (TO) 可以在87.1%的患者中实现. 诸如年龄增长和射出分数减少等因素与非TO相关,突出显示了手术改进的领域.
科学领域:
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
- 医学成果研究研究成果
背景情况:
- 传统的外科手术结果侧重于发病率和死亡率.
- 患者的期望越来越强调没有并发症.
- 教科书结果 (TO) 已经成为理想手术结果的指标.
研究的目的:
- 为了评估在关节 (MV) 手术中实现教科书结果 (TO) 的成就.
- 为了确定与在MV手术中实现或不实现TO相关的患者和程序特定因素.
主要方法:
- 来自荷兰心脏登记 (2013-2021) 的初级选择性MV手术数据的分析.
- TO被定义为1年没有重大并发症的生存 (例如,呼吸不足,中风,功能衰竭,重新干预).
- 包括同时进行的手术,如三角门手术和节律手术.
主要成果:
- 在3026名患者中,87.1%的患者实现了教科书结果 (TO).
- 与非TO相关的因素包括年龄较大,左心室喷射率降低,肺高血压,最近的心肌梗塞,心肌门置换,椎切除方法和节律手术.
- 年龄较大 (OR=1.03),射出率减小 (OR=1.33),肺高血压 (OR=1.30),近期心脏病发作 (OR=4.71),心脏病替代 (OR=1.89),骨切割 (OR=1.30) 和节律手术 (OR=1.33) 是非TO的重要预测因素.
结论:
- 教科书结局 (TO) 是一个临床相关的基准,用于评估手术表现在中枢手术.
- 识别与非TO相关的因素可以指导改善患者治疗结果的努力.
- 进一步验证和将TO应用于其他手术程序是有必要的.
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