性别和年龄对孤立性冠状动脉搭桥手术远期疗效的影响

M. Poteev, R. Yakubov, A. G. Khaisanov
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引用次数: 0

摘要

的目标。冠状动脉搭桥手术后死亡预测因素的研究和长期生存分析。方法。该研究包括2011年至2019年期间在急诊医院(Naberezhnye Chelny)接受孤立冠状动脉搭桥手术的1742名患者,其中345名(19.8%)女性和1397名(80.2%)男性。女性年龄较大:她们的平均年龄为65.896.98岁,而男性为61.297.71岁(p 0.001)。主要终点是术后长期内任何原因导致的死亡。结果。主要终点发生在170例患者中(占总样本的9.8%),包括19例女性和151例男性(11.2比88.8%)。平均随访时间43.6527.55个月,中位随访时间41个月。5年生存率(女性89%,男性76%;P =0.042),女性在整个观察期的总生存率更高(86%对74%;p = 0.042)。多因素Cox回归分析显示,长期生存率与年龄有统计学显著相关:≥59岁[危险比(HR) 0.43;置信区间(CI) 0,280,65;[0,001],年龄在60 - 69岁之间(HR 0,62;CI 0410年,9;* 0,018),性别:女性(HR 0,46;CI 0290, 77;在体外循环期间伴有主动脉阻塞因素(HR 2,42;CI 1之比是13比5 17;使用的胸内动脉数量:1 (HR 0,12;CI 0020, 65;* 0,015)或两个(HR 0,08;CI 0010, 95;р0045)。结论。女性患者的5年生存率和总生存率均较高;女性、年轻等因素显著影响冠状动脉搭桥术后长期随访期的生存率,使其增加。
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Impact of gender and age on long-term outcomes of isolated coronary bypass surgery
Aim. Search for predictors of death and analysis of long-term survival after coronary bypass surgery. Methods. The study included 1742 patients who underwent isolated coronary bypass surgery in Emergency Hospital (Naberezhnye Chelny) between 2011 and 2019, of whom 345 (19.8%) women and 1397 (80.2%) men. The women were older: their average age was 65.896.98 years versus 61.297.71 years for men (p 0.001). The primary end point was death from any cause in the long-term postoperative period. Results. The primary end point occurred in 170 patients (9.8% of the total sample), including 19 women and 151 men (11.2 vs. 88.8%). The average follow-up period was 43.6527.55 months, the median follow-up period 41 months. Both the 5-year survival rate (89% for women against 76% for men; p=0.042) and overall survival rate for the entire observation period were higher in women (86% versus 74%; p=0.042). Multivariate Cox regression analysis revealed that the long-term survival statistically significantly associated with age: up to 59 years [hazard ratio (HR) 0,43; confidence interval (CI) 0,280,65; р 0,001] and aged between 60 and 69 years (HR 0,62; CI 0,410,9; р 0,018), with gender: for female (HR 0,46; CI 0,290,77; р 0,002) and with factor of aortic occlusion during extracorporeal circulation (HR 2,42; CI 1,13-5,17; р 0,022) as well as the number of used internal thoracic arteries: one (HR 0,12; CI 0,020,65; р 0,015) or two (HR 0,08; CI 0,010,95; р 0,045). Conclusion. Both 5-year and overall survival in women was higher; factors such as female gender and young age significantly influence survival in the long-term follow-up period after coronary bypass surgery, increasing it.
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