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一种用于女性血管内介入治疗患者的新死亡率风险评分。

A novel mortality risk score for female patients undergoing endovascular interventions.

机构信息

Department of Cardiology, William Beaumont Hospital, Royal Oak, Michigan, USA.

出版信息

J Interv Cardiol. 2011 Dec;24(6):555-61. doi: 10.1111/j.1540-8183.2011.00669.x. Epub 2011 Aug 25.

Abstract

BACKGROUND

Peripheral arterial disease (PAD) has been described as a rising epidemic in recent years. The majority of subjects studied in PAD literature have been male, leaving female patients an underrepresented population with regard to revascularization outcomes. The goal of our study was to determine the death rate and predictors of mortality in female patients undergoing endovascular intervention (EI) for symptomatic PAD.

METHODS AND RESULTS

This study was conducted as a single-center retrospective chart review of 292 female patients who underwent EI for symptomatic PAD. Patient variables including demographics and procedural data were analyzed for statistical significance with regard to mortality. Age, history of congestive heart failure (CHF), and chronic kidney disease (CKD) were found to be significant predictors of mortality on multivariable analysis. A death risk score was formulated based on the above variables, risk stratifying patients into low, medium, or high risk groups for mortality after EI. Overall, 76 patients (26%) fell into the low risk category with a mortality of 5.3%, 102 patients (35%) fell into the moderate risk with a mortality of 15.7%, and 112 patients (39%) fell into the high-risk group with a mortality of 45.5% (P < 0.0001).

CONCLUSIONS

Our study is the first of its kind to specify predictors of mortality in female patients with symptomatic PAD. This study also provides a tool to identify female PAD patients at high risk for death after EI. Finally, it highlights the effect of CKD, age, and CHF on mortality of patients with PAD.

摘要

背景

近年来,周围动脉疾病(PAD)已被描述为一种日益流行的疾病。PAD 文献中的大多数研究对象都是男性,这使得女性患者在血运重建结果方面代表性不足。我们的研究目的是确定接受血管内介入(EI)治疗有症状 PAD 的女性患者的死亡率和死亡预测因素。

方法和结果

本研究是对 292 例接受 EI 治疗有症状 PAD 的女性患者进行的单中心回顾性图表回顾。对患者变量,包括人口统计学和程序数据进行分析,以确定与死亡率相关的统计学意义。多变量分析显示,年龄、充血性心力衰竭(CHF)病史和慢性肾脏病(CKD)是死亡率的显著预测因素。根据上述变量制定了死亡风险评分,将患者分为 EI 后死亡风险低、中、高的风险组。总的来说,76 例(26%)患者属于低危组,死亡率为 5.3%,102 例(35%)患者属于中危组,死亡率为 15.7%,112 例(39%)患者属于高危组,死亡率为 45.5%(P<0.0001)。

结论

我们的研究首次明确了有症状 PAD 女性患者的死亡预测因素。该研究还提供了一种工具,可识别接受 EI 治疗后死亡风险高的女性 PAD 患者。最后,它强调了 CKD、年龄和 CHF 对 PAD 患者死亡率的影响。

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