经导管二尖瓣修复术（使用MitraClip）后延长住院时间的预测因素。
Predictors for prolonged hospital stay after transcatheter mitral valve repair with the MitraClip.
作者信息
Ledwoch Jakob, Bertog Stefan, Wunderlich Nina, Doss Mirko, Fichtlscherer Stephan, Teufel Tobias, Herholz Tina, Vaskelyte Laura, Hofmann Ilona, Sievert Horst
机构信息
CardioVascular Center Frankfurt, Sankt Katharinen and University Hospital, Frankfurt, Germany.
出版信息
Catheter Cardiovasc Interv. 2014 Oct 1;84(4):599-605. doi: 10.1002/ccd.25460. Epub 2014 Jun 17.
OBJECTIVE
The aim is to find predictors for a prolonged LOHS after MitraClip implantation.
BACKGROUND
Due to its less invasive nature, average length of hospital stay (LOHS) after the MitraClip procedure is shorter compared to mitral valve surgery. However, some patients have a prolonged LOHS.
METHODS
Records of consecutive patients who underwent MitraClip procedure were reviewed. A total of 41 consecutive patients with MitraClip implantation (76 ± 9 years, 59% men) were included. Median hospital stay was 7 days. Hospitalization lasting longer than 7 days was considered prolonged.
RESULTS
Procedural success was achieved in 88% of the cases. In-hospital death occurred in 4 of 41 patients (10%). Patients with a prolonged hospital stay (46%) had a higher EuroSCORE I (22.7% [IQR 10.3-28.3] vs. 6.7% [IQR 3.5-18.3], P = 0.017), a higher STS mortality score (6.1%[(IQR 3.7-7.5] vs. 2.6% [IQR 1.4-4.8]; P = 0.043) and a higher STS long-length-of-stay score (18.9% [IQR 11.3-22.5] vs. 9.6% [IQR 6.2-16.1]; P = 0.039) as well as a lower estimated glomerular filtration rate (eGFR) (41 ml/min/1.73 m(2) [IQR 19-52] vs. 56 ml/min/1.73 m(2) [IQR 49-62]; P = 0.008) than those whose did not. In the multivariate model, lower eGFR was identified as predictor for a prolonged hospitalization.
CONCLUSION
Lower pre-procedure eGFR is independently associated with a longer hospitalization.
目的
旨在寻找经皮二尖瓣缘对缘修复术（MitraClip）植入术后住院时间延长的预测因素。
背景
由于其侵入性较小，与二尖瓣手术相比，MitraClip术后的平均住院时间（LOHS）较短。然而，一些患者的住院时间会延长。
方法
回顾了连续接受MitraClip手术患者的记录。共纳入41例连续接受MitraClip植入术的患者（76±9岁，59%为男性）。中位住院时间为7天。住院时间超过7天被视为延长。
结果
88%的病例手术成功。41例患者中有4例（10%）在住院期间死亡。住院时间延长的患者（46%）的欧洲心脏手术风险评估系统（EuroSCORE）I评分较高（22.7%[四分位间距10.3 - 28.3] vs. 6.7%[四分位间距3.5 - 18.3]，P = 0.017），胸外科医师协会（STS）死亡率评分较高（6.1%[四分位间距3.7 - 7.5] vs. 2.6%[四分位间距1.4 - 4.8]；P = 0.043），STS长住院时间评分较高（18.9%[四分位间距11.3 - 22.5] vs. 9.6%[四分位间距6.2 - 16.1]；P = 0.039），且估算肾小球滤过率（eGFR）较低（41 ml/min/1.73 m²[四分位间距19 - 52] vs. 56 ml/min/1.73 m²[四分位间距49 - 62]；P = 0.008）。在多变量模型中，较低的eGFR被确定为住院时间延长的预测因素。
结论
术前较低的eGFR与较长的住院时间独立相关。
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