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在植入左心室辅助装置后,70 多岁的患者的存活率和预后与年轻患者相似。

Septuagenarian population has similar survival and outcomes to younger patients after left ventricular assist device implantation.

机构信息

LTSI-UMR 1099, INSERM, Service de Cardiologie et Maladies Vasculaires, CHU de Rennes, Université de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France.

LTSI-UMR 1099, INSERM, Service de Cardiologie et Maladies Vasculaires, CHU de Rennes, Université de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France.

出版信息

Arch Cardiovasc Dis. 2020 Nov;113(11):701-709. doi: 10.1016/j.acvd.2020.05.018. Epub 2020 Sep 17.

Abstract

BACKGROUND

Left ventricular assist device (LVAD) implantation may be an attractive alternative therapeutic option for elderly patients with heart failure who are ineligible for heart transplantation.

AIM

We aimed to describe the characteristics and outcomes of elderly patients (i.e. aged≥70 years) receiving an LVAD.

METHODS

This observational study was conducted in 19 centres between 2006 and 2016. Patients were divided into two groups-younger (aged<70 years) and elderly (aged≥70 years), based on age at time of LVAD implantation.

RESULTS

A total of 652 patients were included in the final analysis, and 74 patients (11.3%) were aged≥70 years at the time of LVAD implantation (maximal age 77.6 years). The proportion of elderly patients receiving an LVAD each year was constant, with a median of 10.6% (interquartile range 8.0-15.4%) per year, and all were implanted as destination therapy. Elderly and younger patients had similar durations of hospitalization in intensive care units and total lengths of hospital stays. Both age groups experienced similar rates of LVAD-related complications (i.e. stroke, bleeding, driveline infection and LVAD exchange), and the occurrence of LVAD complications did not impact survival in the elderly group compared with the younger group. Lastly, when compared with younger patients implanted as destination therapy, the elderly group also exhibited similar mid-term survival.

CONCLUSION

This work strongly suggests that selected elderly adults can be scheduled for LVAD implantation.

摘要

背景

左心室辅助装置(LVAD)植入可能是一种有吸引力的治疗选择,适用于不符合心脏移植条件的老年心力衰竭患者。

目的

我们旨在描述接受 LVAD 的老年患者(即年龄≥70 岁)的特征和结局。

方法

这项观察性研究于 2006 年至 2016 年在 19 个中心进行。根据 LVAD 植入时的年龄,患者分为两组:年轻组(年龄<70 岁)和老年组(年龄≥70 岁)。

结果

共有 652 名患者纳入最终分析,74 名患者(11.3%)在 LVAD 植入时年龄≥70 岁(最大年龄 77.6 岁)。每年接受 LVAD 治疗的老年患者比例保持不变,中位数为每年 10.6%(四分位间距 8.0-15.4%),所有患者均作为终末期治疗植入。老年组和年轻组在重症监护病房的住院时间和总住院时间方面相似。两组患者 LVAD 相关并发症(即卒中、出血、导线感染和 LVAD 更换)的发生率相似,与年轻组相比,LVAD 并发症的发生并未影响老年组的生存。最后,与作为终末期治疗植入的年轻患者相比,老年组也表现出相似的中期生存率。

结论

这项工作强烈表明,选择合适的老年患者可以接受 LVAD 植入。

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