在老年人中选择 mitra 假肢. 对实际结果的分析
E A Grossi1, A C Galloway, P K Zakow
1Department of Surgery, New York University Medical Center, NY 10016, USA. grossi@cv.med.nyu.edu
Circulation
|December 16, 1998
概括
在接受关节置换的老年患者中,实际分析显示,生物假肢和机械假肢对退化和并发症的自由性类似,而保险学分析高估了风险.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 生物医学工程 生物医学工程
背景情况:
- 机械假肢 (MP) 在年轻的患者中是最受青的,因为由于生物假肢 (BPs) 退化,为配心置换 (MVR) 进行.
- 老年患者面临着非心脏病死亡 (NCD) 等竞争性风险,可能会改变门选择的风险效益.
- 精算分析通过不考虑死亡率,高估了老年人膜退行风险.
研究的目的:
- 为了比较精算和累积发病率 (实际) 分析,在接受MVR的老年患者中,免受膜退化 (VD) 的情况.
- 在70岁及以上的患者中,评估生物假肢与机械 mitra 置换的长期结果.
主要方法:
- 追溯分析504名70岁以上的患者,他们在1976年至1996年期间接受了MVR.
- 使用精算和实际 (累计发病率) 方法比较10年没有变 (VD) 和相关并发症 (VRCs).
- 基于假肢类型的结果分层:生物假肢 (BP) 与机械假肢 (MP).
主要成果:
- 在BP (15.9%) 和MP (18.5%) 之间,医院死亡率相当.
- 对于BP (92.6%) 和MP (95.4%) 两者来说,10年的实际无风险高.
- 从所有VRC中获得10年的实际自由率也是相似的:BP的84.4%,MP的92.3%.
结论:
- 与实际分析相比,精算分析显著高估了老年MVR患者的血管疾病10年风险.
- 在老年患者中,在生物假体门和机械门之间,实际免于VD和VRC并没有显著差异.
- 老年人选择假肢可能取决于抗凝血要求等因素,而不是膜退化风险.
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