心力衰竭是手术后静脉血栓栓塞的一个主要危险因素,在减肥手术患者
Zubaidah Nor Hanipah1, Florina Corpodean2, Michael Kachmar2
1Metamor Institute, Pennington Biomedical Research Center at Louisiana State University, Baton Rouge, LA, USA.
概括
心力衰竭显著增加了腹手术后静脉血栓栓塞 (VTE) 的风险. 患有心力衰竭的患者患有静脉瘤的可能性几乎是两倍,因此需要采取有针对性的预防措施.
科学领域:
- 腹部外科手术的结果
- 心血管并发症 心血管并发症
- 血栓塞栓事件的预防
背景情况:
- 确定手术前发生术后血栓栓塞的危险因素 (例如,深静脉血栓塞[DVT],肺栓塞[PE]) 对于有针对性的预防策略至关重要.
- 代谢和腹腔外科质量改善项目 (MBSAQIP) 数据库现在包括手术前心力衰竭数据,这是已知的DVT/PE风险因素.
研究的目的:
- 分析2023年MBSAQIP数据库,以识别和排名与代谢和腹部外科手术 (MBS) 患者的术后DVT/PE风险相关的术前因素.
- 特别研究心力衰竭与术后血栓栓塞事件的关联.
主要方法:
- 使用了2023年MBSAQIP数据库 (n = 217,952名患者).
- 采用多变量逻辑回归来评估术后DVT和PE的预测因素.
- 调整以人口统计,手术前并发症和手术变量为准.
主要成果:
- 心力衰竭史是术后血栓栓塞事件的第二高危险因素 (几率比: 1.73).
- 其他重大风险因素包括先前的DVT/PE,年龄较大,BMI较高,男性性别,肝病和GERD.
- 主要手术和治疗性抗凝药与降低风险有关.
结论:
- 患有心力衰竭病史的患者在减肥手术后患有静脉动脉突发症的可能性增加了近两倍.
- 心力衰竭应该被认为是这种人群中风险高的VTE因素.
- 考虑对心力衰竭患者进行静脉瘤预防,这些患者的心力衰竭类似于以前有DVT/PE的患者.
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