JAHA:左侧感染性心内膜炎老年患者未充分接受手术治疗

2021-09-24 MedSci原创 MedSci原创

与年轻患者相比,老年感染性心内膜炎患者接受手术的比例较低。无论年龄大小,手术与较低的死亡率相关。在匹配的老年患者中,未接受手术的患者长期死亡率较高,表明老年患者并未充分开展手术。

感染性心内膜炎与老年患者较高的死亡率相关,但手术在该类患者中的作用尚未得到充分评估。

近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,该研究的目的是评估老年患者左侧感染性心内膜炎的结局,并明确手术对老年人死亡率的影响。

研究人员对瑞典感染性心内膜炎登记处(SRIE)记录的2186例左侧感染性心内膜炎患者进行了全国性回顾性研究,患者分为年龄<65岁(n=864)、65至79岁(n=806)、以及80岁以上(n=516)。研究人员使用瑞典国家人口登记处进行生存分析,并应用倾向评分匹配来评估手术对所有年龄患者生存率的影响。

研究人员发现手术率随着年龄的增长而下降,从65岁以下组为46%,而80岁以上组为6%。与65岁以下组相比,80岁以上组的住院死亡率高出3倍(23% vs. 7%),几乎是65至79岁组(12%)的两倍。在倾向匹配组中,与未接受手术的患者相比,55至82岁之间的接受手术的患者死亡率显著降低。在匹配的75岁以上患者中,手术还与更好的长期生存率相关(风险比为0.36;95%CI为0.24-0.54[P<0.001])。

由此可见,与年轻患者相比,老年感染性心内膜炎患者接受手术的比例较低。无论年龄大小,手术与较低的死亡率相关。在匹配的老年患者中,未接受手术的患者长期死亡率较高,表明老年患者并未充分开展手术。

原始出处:

Sigurdur Ragnarsson.et al.Surgery Is Underused in Elderly Patients With Left‐Sided Infective Endocarditis: A Nationwide Registry Study.JAHA.2021.https://www.ahajournals.org/doi/10.1161/JAHA.120.020221

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    2021-09-25 zerohahaha

    好文章,学习了

    0

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