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JAHA:冠状动脉旁路移植术患者的虚弱与长期生存率的关系

2018-07-20 xing.T MedSci原创

由此可见,大部分接受冠状动脉旁路移植术的患者存在虚弱症状,并且与长期死亡率独立相关。调整后的虚弱相关死亡风险与年龄呈负相关。该研究结果强调需要更全面的术前风险分层模型,以帮助选择最佳的手术候选人。此外,该研究将<75岁年龄组确定为综合术前优化计划(例如心脏康复、营养增强和社会心理支持)的潜在目标人群。

虚弱的患病率正在不断增加,并为临床医生带来了巨大的挑战。心脏外科文献大部分是小型单中心研究并且随访时间有限,在长期随访中虚弱的流行病学特征仍有待阐明。

近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员于2008年至2015年期间在加拿大安大略省进行了一项基于人群的回顾性队列研究,通过使用约翰霍普金斯校正临床组虚弱指标(一种使用行政数据进行研究验证的多维工具)来定义虚弱。该研究的主要结局是死亡率。研究人员使用Kaplan-Meier方法计算死亡率,并使用多变量Cox比例风险模型评估死亡风险。

在40083例接受冠状动脉旁路移植术的患者中,8803例(22%)患者存在虚弱症状。随访4±2年,虚弱患者(33; 95%置信区间为29-36)与非虚弱患者(22; 95%置信区间为19-24)相比,每1000人每年经年龄和性别标准化的死亡率更高。虚弱与长期死亡风险增加(校正后风险比为1.20; 95%置信区间为1.12-1.28)相关,并且40-74岁患者的生存率差异比≥85岁的患者更大。

由此可见,大部分接受冠状动脉旁路移植术的患者存在虚弱症状,并且与长期死亡率独立相关。调整后的虚弱相关死亡风险与年龄呈负相关。该研究结果强调需要更全面的术前风险分层模型,以帮助选择最佳的手术候选人。此外,该研究将<75岁年龄组确定为综合术前优化计划(例如心脏康复、营养增强和社会心理支持)的潜在目标人群。

原始出处:

Diem T. T. Tran.et al. Association of Frailty and Long‐Term Survival in Patients Undergoing Coronary Artery Bypass Grafting.JAHA.2018. https://doi.org/10.1161/JAHA.118.009882

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    2019-02-04 cy0324
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channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Sun Jul 22 05:43:42 CST 2018, time=2018-07-22, status=1, ipAttribution=)]
    2018-09-08 米迷谜

    学习了

    0

  4. 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  5. 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channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Sun Jul 22 05:43:42 CST 2018, time=2018-07-22, status=1, ipAttribution=)]
    2018-07-22 zhaohui6731
  6. 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  7. 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  9. 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    2018-07-22 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

  10. 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    2018-07-22 哈哈869

    学了

    0

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