老年患者左心室辅助装置应用的并发症。
Complications of LVAD utilization in older adults.
机构信息
Department of Internal Medicine, McGovern Medical School, Houston, TX.
Department of Internal Medicine: Geriatric and Palliative Care Medicine, McGovern Medical School, 6431 Fannin St MSB 5.126 Houston, TX 77030, USA.
出版信息
Heart Lung. 2021 Jan-Feb;50(1):75-79. doi: 10.1016/j.hrtlng.2020.07.009. Epub 2020 Jul 22.
BACKGROUND
Yearly rate and mean patient age of left ventricular assist device (LVAD) implantation increased from 2009 to 2014. Data are lacking regarding trends of LVAD implantation in older adults.
OBJECTIVES
To describe the trends of LVAD implantation in older adults and the clinical impact of associated procedural complications.
METHODS
We retrospectively analyzed the National Inpatient Sample from 2005 to 2014, calculated the percentage of older adults (>65 years of age) among those who underwent LVAD implantation, and compared their clinical characteristics. Primary outcomes were in-hospital mortality and discharge home.
RESULTS
In total, 4491 patients were included. The percentage of older adults among those receiving LVAD increased from 12.53% to 31.65% (p<0.01). Older adults were more likely to develop postoperative delirium (17.90% vs. 11.92% in younger patients; p<0.01), which portended lesser odds of discharge home.
CONCLUSIONS
Delirium develops with greater incidence in older adults undergoing LVAD implantation, which decreases odds of favorable discharge disposition.
背景
从 2009 年到 2014 年，每年左心室辅助装置（LVAD）植入的速率和平均患者年龄都有所增加。关于老年人中 LVAD 植入的趋势的数据尚缺乏。
目的
描述老年人中 LVAD 植入的趋势以及相关手术并发症的临床影响。
方法
我们回顾性分析了 2005 年至 2014 年的全国住院患者样本，计算了接受 LVAD 植入的患者中年龄较大的老年人（>65 岁）的百分比，并比较了他们的临床特征。主要结局是住院期间死亡率和出院回家。
结果
共纳入 4491 例患者。接受 LVAD 治疗的老年人比例从 12.53%增加到 31.65%（p<0.01）。老年人更有可能发生术后谵妄（17.90%比年轻患者的 11.92%；p<0.01），出院回家的可能性较小。
结论
在接受 LVAD 植入的老年人中，谵妄的发生率更高，这降低了出院处置良好的可能性。
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