在国家创伤数据库中的腹腔大动脉创伤结果
Vahe S Panossian1, Tiemen E T Holtrop1, Yasmin Arda1
1Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
The Journal of surgical research
|December 28, 2025
概括
内血管大动脉修复 (EVAR) 显示,与开放修复相比,腹部大动脉创伤 (AAT) 患者的死亡率较低. 这一发现对于改善严重AAT病例的结果至关重要.
科学领域:
- 创伤外科 手术 创伤外科
- 血管外科 血管外科
- 紧急医疗 紧急医疗
背景情况:
- 腹腔大动脉创伤 (AAT) 是一种罕见但危及生命的疾病,死亡率高.
- 对于AAT,手术是必要的,开放修复和内血管大动脉修复 (EVAR) 是主要的治疗选择.
研究的目的:
- 为了比较AAT患者的开放修复与EVAR的结果.
- 为了确定与AAT患者死亡率相关的因素.
主要方法:
- 美国外科医生学院创伤质量改善计划数据库 (2017-2020年) 的回顾性分析.
- 包括年龄≥18岁的AAT接受开放修复或EVAR的患者.
- 多变量后勤回归用于确定住院死亡率的独立预测因素.
主要成果:
- 在369名AAT患者中,整体死亡率为47.5%.
- 死亡率增加的独立预测因素包括年龄较大,低格拉斯哥昏迷表,低血压,重创伤和枪伤.
- 与开放式修复相比,EVAR与医院内死亡率显著降低相关 (aOR,0.33;P = 0.019).
结论:
- 即使是到达手术室的患者,AAT也会带来显著的死亡风险.
- 与传统的开放性修复相比,EVAR独立地与AAT患者的死亡率降低有关.
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