JACC:植入式心脏复律除颤器在老年患者中的效果怎么样呢?

2017-01-19 MedSci MedSci原创

用于二级预防心脏性猝死的植入式心脏复律除颤器(ICDs)在近20年前进行了临床试验,这些临床试验招募了少数老年患者。在目前临床实践中,本研究评估了接受ICDs进行二级预防的老年患者的发病率和死亡率。在2006年至2009年间,研究人员从美国国家心血管数据登记处ICD登记处确定了12,420名医疗保险受益人,这些患者在956家美国医院进行了首次二级预防ICD植入。研究人员使用医疗索赔在2年内在不同年

用于二级预防心脏性猝死的植入式心脏复律除颤器(ICDs)在近20年前进行了临床试验,这些临床试验招募了少数老年患者。

在目前临床实践中,本研究评估了接受ICDs进行二级预防的老年患者的发病率和死亡率。

在2006年至2009年间,研究人员从美国国家心血管数据登记处ICD登记处确定了12,420名医疗保险受益人,这些患者在956家美国医院进行了首次二级预防ICD植入。研究人员使用医疗索赔在2年内在不同年龄层(65至69岁,70至74岁,75至79岁,以及≥80岁)中评估了死亡,住院和进入专业护理机构(SNF)的风险。研究人员使用多变量模型评估了年龄和结果之间关联。

这些患者植入时的平均年龄为75岁;25.3%<70岁,25.7%≥80岁。总体而言,2年时的死亡风险为21.8%,从<70岁的14.7%到≥80岁的28.9%(调整风险比[aRR]:2.01;95%置信区间[CI ]:1.85至2.33;趋势p<0.001)。住院的累积发生率为65.4%,从<70岁的60.5%到≥80岁的71.5%(aRR:1.27;95%CI:1.19至1.36;趋势p<0.001)。进入SNF的累积发生率从≥70岁的13.1%到≥80岁的31.9%(aRR:2.67;95%CI:2.37至3.01;趋势p<0.001);SNF入院风险在前30天最高。

几乎1/5的接受二级预防ICD的老年患者至少存活2年。鉴于高住院率和SNF入院率,特别是在最老的患者中,所以在植入后需要识别实质性护理需要。

原始出处:

Jarrod K. Betz, David F. Katz, Pamela N. Peterson,et al.Outcomes Among Older Patients Receiving Implantable Cardioverter-Defibrillators for Secondary Prevention,JACC,2017.1.19


本文系梅斯医学(MedSci)原创编译整理,转载需授权!

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    2017-06-15 hb2008ye
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    2017-03-18 hbwxf

    #JACC#

    0

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    2017-08-19 villahu
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    2017-01-21 12498568m50暂无昵称

    #ACC#

    0

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    2017-01-21 zhouqu_8

    #除颤#

    0

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    2017-01-21 jiyangfei

    #植入#

    0