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经皮冠状动脉介入治疗后年龄与住院死亡率相关性的变化趋势:国家心血管数据注册研究。

Trends in the association between age and in-hospital mortality after percutaneous coronary intervention: National Cardiovascular Data Registry experience.

机构信息

Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn 55905, USA.

出版信息

Circ Cardiovasc Interv. 2009 Feb;2(1):20-6. doi: 10.1161/CIRCINTERVENTIONS.108.826172. Epub 2009 Feb 10.

Abstract

BACKGROUND

Temporal trends and contemporary data characterizing the impact of patient age on in-hospital outcomes of percutaneous coronary interventions are lacking. We sought to determine the importance of age by assessing the in-hospital mortality of stratified age groups in the National Cardiovascular Data Registry.

METHODS AND RESULTS

In-hospital mortality after percutaneous coronary intervention on 1 410 069 patients was age stratified into 4 groups-group 1 (age <40, n=25 679), group 2 (40 to 59, n=496 204), group 3 (60 to 79, n=732 574), and group 4 (>or=80, n=155 612)-admitted from January 1, 2001, to December 31, 2006. Overall in-hospital mortality was 1.22%; in-hospital mortality was 0.60%, 0.59%, 1.26%, and 3.16% in groups 1 to 4, respectively, P<0.0001. Overall temporal improvement per calendar year in the adjusted in-hospital mortality after percutaneous coronary intervention was noted in most groups; however, this finding was significant only in the 2 older age groups, group 3 (odds ratio, 0.94; 95% CI, 0.92 to 0.96) and group 4 (odds ratio, 0.95; 95% CI, 0.92 to 0.97). The absolute mortality reduction was greatest in the most elderly group, those over the age of 80 years.

CONCLUSIONS

In-hospital mortality after percutaneous coronary intervention has fallen for all age groups over the past 6 years. However, the largest absolute reduction was seen among patients 80 years of age or older.

摘要

背景

目前缺乏关于患者年龄对经皮冠状动脉介入治疗住院结局影响的时间趋势和当代数据。我们旨在通过评估国立心血管数据注册中心各年龄组分层的住院死亡率来确定年龄的重要性。

方法和结果

1410069 例经皮冠状动脉介入治疗患者的住院死亡率按年龄分为 4 组:第 1 组(年龄<40 岁,n=25679)、第 2 组(40 至 59 岁,n=496204)、第 3 组(60 至 79 岁,n=732574)和第 4 组(年龄≥80 岁,n=155612),患者于 2001 年 1 月 1 日至 2006 年 12 月 31 日期间入院。总的住院死亡率为 1.22%;第 1 至 4 组的住院死亡率分别为 0.60%、0.59%、1.26%和 3.16%,P<0.0001。大部分组中均观察到经皮冠状动脉介入治疗后,随着时间推移每年调整后住院死亡率的改善,但仅在 2 个较年长的年龄组中具有统计学意义,第 3 组(比值比,0.94;95%可信区间,0.92 至 0.96)和第 4 组(比值比,0.95;95%可信区间,0.92 至 0.97)。最年长组(年龄>80 岁)的绝对死亡率降低幅度最大。

结论

过去 6 年来,所有年龄组经皮冠状动脉介入治疗后的住院死亡率均有所下降。然而,80 岁及以上患者的绝对死亡率降低幅度最大。

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