在感染性内心炎的心脏手术中,贫血和输血
Jennifer S Breel1, Catilin Bozic1, Tim Alberts1
1Cardiology, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands.
Heart (British Cardiac Society)
|December 29, 2025
概括
手术前的贫血和红细胞 (RBC) 输血在感染性内心炎 (IE) 手术中很常见. 红细胞输血独立地预测了更高的死亡率,强调了在这些高风险患者中更好地管理贫血的需要.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 外科手术的结果
背景情况:
- 传染性内心炎 (IE) 经常需要心脏手术,贫血是常见的并发症.
- 在手术治疗的IE患者中,患病率,输血实践和与贫血相关的结果尚未确定.
- 这项研究调查了手术前贫血,输血管理,以及它们对IE手术死亡率的影响.
研究的目的:
- 为了确定手术前贫血的发病率和严重程度,在患者接受门手术的IE.
- 描述红细胞输血和凝血管理实践.
- 评估贫血和红细胞输血与死亡率的关联,考虑基于性别的差异.
主要方法:
- 使用荷兰心脏登记数据 (2016-2023) 进行回顾性多中心队列研究.
- 包括接受活跃IE门手术的成年患者;根据世卫组织标准定义的贫血.
- 卡普兰-梅尔和考克斯的比例危险模型分析了与30天和1年死亡率的关联,并对多个共变量进行了调整.
主要成果:
- 在2480名患者中,84.9%患有手术前贫血 (50.7%中度,2.8%严重);78.7%接受红细胞输血.
- 30天和1年的死亡率分别为10.6%和16.6%.
- 红细胞输血独立预测死亡率 (aHR为30天3.58);女性患者的输血率和死亡率更高.
结论:
- 贫血和红细胞输血在IE手术中非常普遍,并且与死亡率增加有关.
- 红细胞输血是IE手术中不良结果的独立预测因素.
- 改善贫血管理和个性化输血策略对于IE患者至关重要.
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