种族和慢性阻塞性肺疾病对冠状动脉旁路移植术后长期生存的影响。
The effect of race and chronic obstructive pulmonary disease on long-term survival after coronary artery bypass grafting.
作者信息
Efird Jimmy T, O'Neal Wesley T, Anderson Curtis A, O'Neal Jason B, Kindell Linda C, Ferguson T Bruce, Chitwood W Randolph, Kypson Alan P
机构信息
Department of Cardiovascular Sciences, East Carolina Heart Institute, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; Center for Health Disparities Research, Brody School of Medicine, East Carolina University, Greenville, NC, USA.
出版信息
Front Public Health Serv Syst Res. 2013 Apr 3;1. doi: 10.3389/fpubh.2013.00004.
BACKGROUND
Chronic obstructive pulmonary disease (COPD) is a known predictor of decreased long-term survival after coronary artery bypass grafting (CABG). Differences in survival by race have not been examined.
METHODS
A retrospective cohort study was conducted of CABG patients between 2002 and 2011. Long-term survival was compared in patients with and without COPD and stratified by race. Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model.
RESULTS
A total of 984 (20%) patients had COPD (black = 182; white = 802) at the time of CABG ( = 4,801).The median follow-up for study participants was 4.4 years. COPD was observed to be a statistically significant predictor of decreased survival independent of race following CABG (no COPD: HR = 1.0; white COPD: adjusted HR = 1.9, 95% CI = 1.7-2.3; black COPD: adjusted HR = 1.6, 95% CI = 1.1-2.2).
CONCLUSION
Contrary to the expected increased risk of mortality among black COPD patients in the general population, a similar survival disadvantage was not observed in our CABG population.
背景
慢性阻塞性肺疾病（COPD）是冠状动脉旁路移植术（CABG）后长期生存率降低的已知预测因素。种族对生存率的差异尚未得到研究。
方法
对2002年至2011年间接受CABG的患者进行了一项回顾性队列研究。比较了有和没有COPD的患者的长期生存率，并按种族进行分层。使用Cox回归模型计算风险比（HR）和95%置信区间（CI）。
结果
共有984例（20%）患者在接受CABG时患有COPD（黑人=182例；白人=802例）（n=4801）。研究参与者的中位随访时间为4.4年。观察到COPD是CABG后独立于种族的生存率降低的统计学显著预测因素（无COPD：HR=1.0；白人COPD：调整后HR=1.9，95%CI=1.7-2.3；黑人COPD：调整后HR=1.6，95%CI=1.1-2.2）。
结论
与一般人群中黑人COPD患者预期的死亡率增加风险相反，在我们的CABG人群中未观察到类似的生存劣势。
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