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右心室功能障碍对主动脉内球囊泵置入患者预后的影响:一项回顾性全国性分析(2016-2020 年)。

Impact of right ventricular dysfunction on outcomes in patients requiring intra-aortic balloon pump placement: A retrospective nationwide analysis (2016-2020).

机构信息

Department of Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.

Department of Medicine, Ascension Illinois Saint Joseph hospital, Chicago, IL, USA.

出版信息

Curr Probl Cardiol. 2024 Jul;49(7):102611. doi: 10.1016/j.cpcardiol.2024.102611. Epub 2024 May 1.

DOI:10.1016/j.cpcardiol.2024.102611
PMID:38701997
Abstract

Right ventricular dysfunction (RVD) continues to be a significant contributor to both mortality and morbidity, posing a significant challenge in the management of patients undergoing evaluation for mechanical circulatory support (MCS). Currently, there is a paucity of data regarding outcomes in this subset of patients. We analyzed the National Inpatient Sample database (NIS) to identify adult hospitalizations who underwent intra-aortic balloon pump (IABP) placement with or without co-existence of RVD. Multivariate logistic regression, and linear regression analyses were used to compare outcomes, and adjust for possible confounders. Out of 126,985 hospitalizations who underwent IABP placement, 1,475 (1.2%) had RVD. Patients with RVD who received an IABP had higher adjusted odds of inpatient mortality (Adjusted odds ratio [aOR]: 2.33, 95% confidence interval [CI]: 1.7-3.2, p<0.001) than those without co-existing RVD. Hospitalized patients who underwent IABP placement with RVD had higher adjusted odds of worse hospitalization outcomes in general. Conducting additional prospective studies and clinical trials with an emphasis on further subcategorization of patients with RVD is crucial for determining optimal management strategies for these patients.

摘要

右心室功能障碍(RVD)仍然是导致死亡率和发病率的重要因素,对接受机械循环支持(MCS)评估的患者的管理构成了重大挑战。目前,关于这部分患者的结局数据很少。我们分析了国家住院患者样本数据库(NIS),以确定接受主动脉内球囊泵(IABP)置入术的成年住院患者,以及是否同时存在 RVD。使用多变量逻辑回归和线性回归分析来比较结局,并调整可能的混杂因素。在接受 IABP 置入术的 126985 例住院患者中,有 1475 例(1.2%)存在 RVD。接受 IABP 治疗的 RVD 患者的住院内死亡率调整后优势比(Adjusted odds ratio [aOR]:2.33,95%置信区间 [CI]:1.7-3.2,p<0.001)高于无共存 RVD 的患者。患有 RVD 且接受 IABP 治疗的住院患者的总体住院结局更差的调整后优势比更高。对于 RVD 患者,开展更多以进一步对患者进行细分分类为重点的前瞻性研究和临床试验对于确定这些患者的最佳管理策略至关重要。

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