Akhlaghpasand Mohammadhosein, Mohammadi Ida, Hajnorouzali Amir, Firouzabadi Sharyar Rajai, Hosseinpour Melika, Hajikarimloo Bardia, Yazdani Kaveh Oraii, Zeraatian-Nejad Sam, Eghbali Foolad
Cardiovascular Surgery Research and Development Committee, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Department of Surgery, Surgery Research Center, School of Medicine, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Ann Med Surg (Lond). 2025 Jan 9;87(1):70-75. doi: 10.1097/MS9.0000000000002827. eCollection 2025 Jan.
Acute pulmonary embolism (PE), particularly massive PE, presents significant mortality risk, often necessitating emergency intervention such as surgical embolectomy. The prognosis for patients undergoing such interventions, especially after cardiac arrest, remains poor due to hemodynamic complications. This study aims to evaluate the efficacy of salvage pulmonary embolectomy in patients experiencing cardiac arrest due to massive PE, focusing on survival outcomes and influential risk factors.
Conducted at a single center over 10 years, this retrospective study involved 21 patients who underwent surgical embolectomy post-cardiac arrest due to massive PE. Data were collected on patient demographics, clinical presentation, and outcomes, analyzing factors such as age, hospital stay, and operative details.
Out of 21 patients, 13 survived 1 year post-operation, translating to a 1-year survival rate of 61.90%. Intra-hospital survival was 76.19% (16 patients). Notable findings included a significant association between increased age and higher mortality (hazard ratio = 1.14, = 0.024), and a longer hospital stay post-procedure in non-survivors (hazard ratio = 1.52, = 0.03).
Salvage pulmonary embolectomy can improve survival in patients with massive PE following cardiac arrest. However, outcomes heavily depend on the patient's age and the length of the hospital stay. Future studies should focus on refining surgical techniques and improving pre- and postoperative care to enhance survival rates further.
急性肺栓塞（PE），尤其是大面积肺栓塞，具有显著的死亡风险，常常需要进行紧急干预，如手术取栓。由于血流动力学并发症，接受此类干预的患者，尤其是心脏骤停后的患者，预后仍然很差。本研究旨在评估挽救性肺栓子切除术对因大面积肺栓塞导致心脏骤停患者的疗效，重点关注生存结局和影响风险因素。
这项回顾性研究在一个中心进行，为期10年，涉及21例因大面积肺栓塞心脏骤停后接受手术取栓的患者。收集了患者的人口统计学数据、临床表现和结局，分析了年龄、住院时间和手术细节等因素。
21例患者中，13例术后存活1年，1年生存率为61.90%。院内生存率为76.19%（16例患者）。显著发现包括年龄增加与死亡率升高之间存在显著关联（风险比=1.14，P=0.024），以及非存活者术后住院时间更长（风险比=1.52，P=0.03）。
挽救性肺栓子切除术可提高心脏骤停后大面积肺栓塞患者的生存率。然而，结局在很大程度上取决于患者的年龄和住院时间。未来的研究应侧重于改进手术技术以及改善术前和术后护理，以进一步提高生存率。
