Suppr超能文献

接受冠状动脉旁路移植术的透析依赖患者的风险分析:透析模式对结局的影响。

Risk analysis of dialysis-dependent patients who underwent coronary artery bypass grafting: Effects of dialysis modes on outcomes.

作者信息

Li Han-Yan, Chang Chih-Hsiang, Lee Cheng-Chia, Wu Victor Chien-Chia, Chen Dong-Yi, Chu Pao-Hsien, Liu Kuo-Sheng, Tsai Feng-Chun, Lin Pyng-Jing, Chen Shao-Wei

机构信息

Department of Cardiothoracic and Vascular Surgery, Chang Gung Memorial Hospital, Linkou Medical Center Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University Kidney Research Center, Department of Nephrology Department of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan, ROC.

出版信息

Medicine (Baltimore). 2017 Sep;96(39):e8146. doi: 10.1097/MD.0000000000008146.

Abstract

Cardiovascular disease is the major morbidity and leading cause of mortality for dialysis-dependent patients. This study aimed to stratify the risk factors and effects of dialysis modes in relation to coronary artery bypass grafting (CABG) surgery among dialysis-dependent patients.This retrospective study enrolled dialysis-dependent patients who underwent CABG from October 2005 to January 2015. All data of demographics, medical history, surgical details, postoperative complications, and in-hospital mortality were analyzed, and patients were categorized as those with or without in-hospital mortality and those with preoperative hemodialysis (HD) or peritoneal dialysis (PD).Of 134 enrolled patients, 25 (18.7%) had in-hospital mortality. Multivariate analyses identified that older age [odds ratio (OR): 1.110, 95% confidence interval (CI): 1.030-1.197, P = .006], previous stroke history (OR: 5.772, 95% CI: 1.643-20.275, P = .006), PD (OR: 19.607, 95% CI: 3.676-104.589, P < .001), and emergent operation (OR: 8.788, 95% CI: 2.697-28.636, P < .001) were statistically significant risk factors for in-hospital mortality among dialysis-dependent patients with CABG surgery. Patients with PD had a higher in-hospital mortality rate (58.3% vs 14.8%, P < .001) and lower 1-year overall survival (33.3% vs 56.6%, P = .031) than did HD patients. The major in-hospital mortality cause was cardiac events among HD patients and septic shock among PD patients.Among dialysis patients who received CABG, those with older age, previous stroke history, PD, and emergent operation had higher risks. Those with PD were prone to poorer in-hospital outcomes after CABG surgery.

摘要

心血管疾病是依赖透析患者的主要发病原因和首要死亡原因。本研究旨在对依赖透析患者中与冠状动脉旁路移植术(CABG)相关的透析模式的危险因素及影响进行分层。这项回顾性研究纳入了2005年10月至2015年1月期间接受CABG的依赖透析患者。分析了所有人口统计学、病史、手术细节、术后并发症及院内死亡率数据,并将患者分为有或无院内死亡以及术前接受血液透析(HD)或腹膜透析(PD)的患者。在134例纳入研究的患者中,25例(18.7%)发生了院内死亡。多因素分析确定,年龄较大[比值比(OR):1.110,95%置信区间(CI):1.030 - 1.197,P = 0.006]、既往有卒中病史(OR:5.772,95%CI:1.643 - 20.275,P = 0.006)、PD(OR:19.607,95%CI:3.676 - 104.589,P < 0.001)以及急诊手术(OR:8.788,95%CI:2.697 - 28.636,P < 0.001)是接受CABG手术的依赖透析患者院内死亡的统计学显著危险因素。与HD患者相比,PD患者的院内死亡率更高(58.3%对14.8%,P < 0.001),1年总生存率更低(33.3%对56.6%,P = 0.031)。HD患者院内死亡的主要原因是心脏事件,而PD患者是感染性休克。在接受CABG的透析患者中,年龄较大、既往有卒中病史、接受PD以及急诊手术的患者风险更高。接受PD的患者在CABG手术后院内结局往往较差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a810/5626296/9728b87a9c16/medi-96-e8146-g004.jpg

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验