心脏手术患者特征对1981年至1995年的患者结果的影响
C D Warner1, W S Weintraub, J M Craver
1Emory Healthcare, Atlanta, Ga, USA. cwarner@nurse.emory.edu
Circulation
|October 7, 1997
概括
冠状动脉旁路移植 (CABG) 患者面临越来越大的风险,但死亡率从1993年至1995年大幅下降,这表明对高风险个体的护理得到了改善.
科学领域:
- 心血管外科心血管外科
- 医疗保健服务研究 医疗服务研究
- 患者的治疗结果.
背景情况:
- 之前的研究表明,冠状动脉旁路手术 (CABG) 患者的风险增加.
- 患者风险升级对CABG后住院结果的影响仍未得到充分记录.
- 本研究探讨了患者风险增加的趋势及其对治疗结果的影响.
研究的目的:
- 评估从1993年到1995年,接受CABG的高风险患者的趋势是否继续.
- 为了比较CABG患者在三个不同的时间段 (1981-1987,1988-1992,1993-1995) 的结果.
- 评估患者风险对 CABG 后医院住院结果的影响.
主要方法:
- 对接受CABG的患者进行前性数据收集.
- 用单变量和多变量统计数据比较三个时间段的患者队列.
- 开发物流回归模型来预测死亡风险.
主要成果:
- 在这三个研究期间,观察到患者风险显著增加.
- 在1988-1992年队列中,增加的风险与较高的死亡率相关.
- 尽管风险上升,但1993-1995年队列显示死亡率下降和并发症减少,实际死亡率低于预测.
结论:
- 接受CABG的患者代表着日益高风险的人群.
- 从1993年至1995年,住院死亡率下降,即使患者的风险增加.
- 这种改善可能源于管理高风险患者的专业知识,更好的心肌保护以及手术和麻醉技术的进步.
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