肺动脉内膜切除术:早期和晚期死亡率的风险因素。

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Thoracic and Cardiovascular Surgeon Pub Date : 2024-09-04 DOI:10.1055/a-2409-5944
Sehnaz Olgun Yildizeli, Hüseyin Arikan, Sinem Güngör, Aslı Tufan-Çinçin, Derya Kocakaya, Halil Ataş, Bulent Mutlu, Serpil Gezer Tas, Koray Ak, G Nural Bekiroğlu, Bedrettin Yildizeli
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引用次数: 0

摘要

背景 肺动脉内膜剥脱术是治疗慢性血栓栓塞性肺动脉高压(CTEPH)的一种潜在治疗方法。本研究旨在确定 CTEPH 患者肺动脉内膜剥脱术后短期和长期预后的预测因素,包括年龄。方法 研究纳入了在 2014 年 3 月至 2024 年 1 月期间接受手术的患者。对围手术期和随访数据进行回顾性研究,包括年龄、院内死亡率、1年和5年生存率、肺动脉内膜切除术后重症监护室和住院时间。结果 共有834名连续患者(平均年龄为51±15.3岁)接受了肺动脉内膜切除术并纳入分析。院内死亡率为 7.8%(n = 65),1 年和 5 年的总死亡率分别为 10.6% 和 11.3%。70岁以下患者的院内死亡率为6.7%,而≥70岁患者的院内死亡率为12.4%(P=0.029)。在死亡率的多变量分析中,年龄(p=0.007)和重症监护室住院时间(p= 0.028)成为院内死亡率的独立预测因素,而 Charlson 综合征指数(p=0.007)和≥70 岁患者的院内死亡率(p=0.029)分别为 10.6%和 11.3%。
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Pulmonary Endarterectomy: Risk Factors for Early and Late Mortality.

Background Pulmonary endarterectomy is a potentially curative treatment option for chronic thromboembolic pulmonary hypertension (CTEPH). This study aimed to identify predictors of short- and long-term outcomes after pulmonary endarterectomy for CTEPH patients, including age. Methods Patients who underwent surgery between March 2014 and January 2024 were included in the study. Perioperative and follow-up data were retrospectively studied, including age, in-hospital mortality, one- and five-year survival, and the length of intensive care unit and hospital stays after pulmonary endarterectomy. Results In total, 834 consecutive patients (mean age 51±15.3 years) underwent pulmonary endarterectomy and were included in the analysis. The in-hospital mortality rate was 7.8% (n = 65), while overall mortality rates at one and five years were 10.6% and 11.3%, respectively. The in-hospital mortality rate was 6.7% for patients < 70 years compared to 12.4% for patients ≥70 years (p=0.029). In the multivariate analysis of mortality, age (p=0.007), and length of intensive care unit stay (p= 0.028) emerged as independent predictors of in-hospital mortality, while the Charlson Comorbidity Index (p<0.001) and six-minute walk distance (p=0.005) were also significant predictors of one-year survival. Conclusion Despite higher short-term mortality rates, pulmonary endarterectomy was feasible and well tolerated among elderly patients. Despite surgical advancements, careful patient selection remains crucial, particularly in the presence of comorbidities. Significant clinical and hemodynamic improvements were observed, along with favorable long-term survival outcomes.

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来源期刊
CiteScore
3.40
自引率
6.70%
发文量
365
审稿时长
3 months
期刊介绍: The Thoracic and Cardiovascular Surgeon publishes articles of the highest standard from internationally recognized thoracic and cardiovascular surgeons, cardiologists, anesthesiologists, physiologists, and pathologists. This journal is an essential resource for anyone working in this field. Original articles, short communications, reviews and important meeting announcements keep you abreast of key clinical advances, as well as providing the theoretical background of cardiovascular and thoracic surgery. Case reports are published in our Open Access companion journal The Thoracic and Cardiovascular Surgeon Reports.
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