同时存在的疾病对脏替代疗法生存的影响
Lancet (London, England)
|February 13, 1993
概括
接受置换疗法 (RRT) 的患者的生存率没有改善. 根据共患病率和年龄的风险分层显著影响RRT患者的治疗结果,突出显示需要量身定制的治疗策略.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床流行病学 临床流行病学
- 老年医学 老年医学
背景情况:
- 接受置换疗法 (RRT) 的患者的存活率已经平稳.
- 越来越多的RRT患者是老年人,患有多种非脏相关的健康问题 (共发病).
研究的目的:
- 分析开始RRT的患者的生存趋势.
- 根据年龄和并发症,将患者分为风险组.
- 为了比较不同风险群体和地理中心之间的生存率.
主要方法:
- 在英国阿伯丁和迪进行了一项追溯研究,对375名患者进行了超过6.5年的RRT.
- 根据并发症和年龄,患者被分为低风险,中风险和高风险组.
- 计算了精算生存率,并进行了包括和排除过早死亡 (90天内) 的分析.
主要成果:
- 在风险组中观察到2年生存率的显著差异 (低:86-90%,中:60-70%,高:35-46%).
- 总体生存率为61% (阿伯丁) 和68% (迪),但在排除过早死亡后分别汇聚到73%和74%.
- 在低风险患者 (70岁以下,没有并发症) 中,RRT表现出很高的成功率 (86%的2年生存率).
结论:
- 置换疗法对低风险患者非常有效.
- 非脏并发症显著影响接受RRT的患者的存活率.
- 风险分层和对早期死亡的仔细分析对于在RRT中心之间进行有效比较至关重要.
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