Gao Junyi, Zhao Qing, Cheng Yi
Department of Cardiovascular Medicine, Beijing Shijitan Hospital Affiliated to Capital University of Medical Sciences, Beijing, China.
Department of Diagnostic Ultrasound, Beijing Anzhen Hospital Affiliated to Capital University of Medical Sciences, Beijing, China.
Front Surg. 2024 Sep 3;11:1395518. doi: 10.3389/fsurg.2024.1395518. eCollection 2024.
An intra-aortic balloon pump (IABP) is a mechanical circulatory device frequently used in patients undergoing coronary artery bypass grafting (CABG). As a treatment for perioperative haemodynamic instability, IABP insertion often implicates an adverse outcome. This study aimed to investigate the age- and sex-related disparity in risk factors for perioperative IABP insertion in CABG patients.
A total of 2,460 CABG patients were included and divided into subgroups by age (elderly subgroup, ≥65 years; young subgroup, <65 years) and sex. Basic characteristics were compared between IABP and non-IABP patients in the overall patient group and the subgroups. Multivariate logistic analysis was used to investigate the significant risk factors for perioperative IABP application, and interaction effects among the potential risk factors were analysed. Combined receiver operating characteristic analysis was used to evaluate the prediction value of combined risk factors.
The overall patient group had a mean age of 61.5 years. The application rate of perioperative IABP was 8.0%. A left ventricular ejection fraction (LVEF) <50% significantly correlated with perioperative IABP application in the overall patient group and the subgroups. Traditional factors such as myocardial infarction history, atrial fibrillation history, and intraoperative estimated blood loss were significant risk factors in certain subgroups. Small dense low-density lipoprotein levels were significantly associated with IABP insertion in the male subgroup and young subgroup. The area under the curve of combined risk factors was significantly higher than that of LVEF <50% alone in the overall patient group and subgroups.
Age- and sex-related differences were present in the risk factor distribution for perioperative IABP insertion in CABG patients.
主动脉内球囊反搏泵（IABP）是一种机械循环装置，常用于接受冠状动脉旁路移植术（CABG）的患者。作为围手术期血流动力学不稳定的一种治疗方法，IABP置入术常伴有不良后果。本研究旨在调查CABG患者围手术期IABP置入术危险因素的年龄和性别差异。
共纳入2460例CABG患者，并按年龄（老年亚组，≥65岁；年轻亚组，<65岁）和性别分为亚组。比较总体患者组和亚组中IABP患者与非IABP患者的基本特征。采用多因素logistic分析探讨围手术期IABP应用的显著危险因素，并分析潜在危险因素之间的交互作用。采用联合受试者工作特征分析评估联合危险因素的预测价值。
总体患者组的平均年龄为61.5岁。围手术期IABP的应用率为8.0%｡左心室射血分数（LVEF）<50%与总体患者组及各亚组围手术期IABP应用显著相关。心肌梗死病史、心房颤动病史和术中估计失血量等传统因素在某些亚组中是显著危险因素。小而密的低密度脂蛋白水平与男性亚组和年轻亚组的IABP置入显著相关。在总体患者组和亚组中，联合危险因素的曲线下面积显著高于单独的LVEF<50%。
CABG患者围手术期IABP置入术的危险因素分布存在年龄和性别差异。
