Rettig Thijs C D, Rigter Sander, Nijenhuis Vincent J, van Kuijk Jan-Peter, ten Berg Jurriën M, Heijmen Robin H, van de Garde Ewoudt M W, Noordzij Peter G
Departments of Anesthesiology, Intensive Care and Pain Medicine.
Cardiology.
J Cardiothorac Vasc Anesth. 2015 Apr;29(2):283-7. doi: 10.1053/j.jvca.2014.10.005. Epub 2015 Jan 31.
Despite the minimally invasive nature of transcatheter aortic valve implantation (TAVI), the incidence of acute kidney injury (AKI) and mortality is of major concern. Several studies showed that outcome was influenced by the systemic inflammatory response syndrome (SIRS) in patients undergoing percutaneous TAVI. The purpose of this study was to investigate whether SIRS after transapical TAVI was associated with short-term outcome.
Retrospective analysis of prospectively collected data.
Intensive care unit in a tertiary-care hospital.
In 121 patients undergoing transapical TAVI for severe aortic stenosis between March 2010 and October 2013, the incidence of SIRS during the first 48 hours was studied. The relation between the occurrence of SIRS and any adverse event during hospital stay was investigated. Any adverse event was defined as the composite of mortality, AKI, infection, stroke, myocardial infarction, and bleeding.
none.
Sixty-five (53.7%) patients developed SIRS during 48 hours after transapical TAVI. The occurrence of SIRS was associated independently with an increased risk of any adverse event (adjusted odds ratio: 4.0, 95% confidence interval [CI]: 1.6-9.6; p=0.002), which was mainly an increased risk of death (odds ratio: 5.5, 95% CI: 1.1-25.9; p=0.031). Patients with SIRS had a longer median duration of intensive care unit stay compared with patients without SIRS (2 v 1 day; p<0.001).
SIRS predicts short-term outcome in patients undergoing transapical TAVI.
尽管经导管主动脉瓣植入术（TAVI）具有微创性，但急性肾损伤（AKI）的发生率和死亡率仍是主要关注点。多项研究表明，接受经皮TAVI的患者的全身炎症反应综合征（SIRS）会影响预后。本研究的目的是调查经心尖TAVI术后的SIRS是否与短期预后相关。
对前瞻性收集的数据进行回顾性分析。
一家三级医院的重症监护病房。
在2010年3月至2013年10月期间接受经心尖TAVI治疗严重主动脉瓣狭窄的121例患者中，研究了最初48小时内SIRS的发生率。调查了SIRS的发生与住院期间任何不良事件之间的关系。任何不良事件定义为死亡、AKI、感染、中风、心肌梗死和出血的综合。
无。
65例（53.7%）患者在经心尖TAVI术后48小时内发生SIRS。SIRS的发生与任何不良事件风险增加独立相关（调整后的优势比：4.0，95%置信区间[CI]：1.6 - 9.6；p = 0.002），主要是死亡风险增加（优势比：5.5，95% CI：1.1 - 25.9；p = 0.031）。与未发生SIRS的患者相比，发生SIRS的患者重症监护病房住院时间中位数更长（2天对1天；p < 0.001）。
SIRS可预测经心尖TAVI患者的短期预后。
