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Heart：TAVI后患者早期死亡的预测因素

2014-04-22 小田 译 医学论坛网

TAVI早期死亡预测因素
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法国学者探讨了经导管主动脉瓣置入术(TAVI)后患者早期死亡的预测因素并试图制作并验证一种较为简便的危险评分方法。结果表明，TAVI术后患者早期死亡主要与年龄、症状严重度、并存疾病和经心尖途径操作有关。一种简单的评分可用于预测患者TAVI后早期死亡，但对于高危患者的精确鉴别而言，这种评分方法的中度鉴别力为其局限性。研究论文4月16日在线发表于《心脏》(Heart)杂志。 该研究将3833例序贯性

法国学者探讨了经导管主动脉瓣置入术(TAVI)后患者早期死亡的预测因素并试图制作并验证一种较为简便的危险评分方法。结果表明，TAVI术后患者早期死亡主要与年龄、症状严重度、并存疾病和经心尖途径操作有关。一种简单的评分可用于预测患者TAVI后早期死亡，但对于高危患者的精确鉴别而言，这种评分方法的中度鉴别力为其局限性。研究论文4月16日在线发表于《心脏》(Heart)杂志。

该研究将3833例序贯性患者随机分为两个队列，每个队列分别有2552例和1281例患者，分别制定和验证一种预测30天或院内死亡的评分系统。

结果显示，应用爱德华Sapien假体和美敦力Corevalve瓣膜的患者数分别为2551例 (66.8%)和1270 例(33.2%)。经股动脉途径、经心尖途径、经锁骨下途径和其他途径操作的患者数分别为2801 (73.4%)、678 (17.8%)、219 (5.7%)和117 (3.1%)。共382例(10.0% )患者发生早期死亡。多变量回归模型分析显示，早期死亡的预测因素为年龄≥90岁、体质指数(BMI)<30 Kg/m2、纽约心功能分级(NYHA)IV级、肺动脉高压、危险的血流动力学状态、过去一年中≥2次的肺水肿、呼吸衰竭、透析和经心尖途径或其他途径(经主动脉途径和经颈动脉途径)操作。研究者推导出了21预测评分法(21-point predictive score)，在制定和验证队列中，这种评分法与观察到的30天死亡率有较好的一致性。

原始出处：


Iung B1, Laouénan C, Himbert D, Eltchaninoff H, Chevreul K, Donzeau-Gouge P, Fajadet J, Leprince P, Leguerrier A, Lièvre M, Prat A, Teiger E, Laskar M, Vahanian A, Gilard M; for the FRANCE 2 Investigators.Predictive factors of early mortality after transcatheter aortic valve implantation: individual risk assessment using a simple score.Heart. 2014 Apr 16. doi: 10.1136/heartjnl-2013-305314. 

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    2015-01-26 yuhaisheng_ibp_32061711

    #早期死亡#

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    2014-04-24 朱睿睿

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    2014-04-24 zhaojie88

    #ART#

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    2014-04-24 爆笑小医

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