高龄患者起搏器术后急性并发症及危险因素

Risk factors and rate of acute complications after pacemaker implantation in elderly patients

目的观察高龄(>80岁)患者起搏器术后急性并发症发生率及危险因素。方法入选2014年1月至2018年1月共127例植入心脏起搏器的高龄患者,观察60天随访期内急性并发症的发生率,对相关因素进行多因素Logistic回归分析。结果共127例患者中,随访期间出现并急性发症者21例(16.5%),其中电极脱位1例(0.8%),气胸2例(1.6%),局部血肿9例(71%),术侧神经损伤2例(1.6%),皮下气肿1例(0.8%),静脉血栓1例(0.8%),心包积液1例(0.8%),术后室性心律失常4例(3.1%)。多因素Logistic逐步回归分析显示,女性、身体质量指数(BMI)低、合并心房颤动对出现急性并发症具有统计学意义(p<0.05)。结论高龄患者永久起搏器植入术后发生急性并发症比例为16.5%,相关危险因素为女性、BMI低、心房颤动,需加强此类高龄患者起搏器术后的治疗及监测。

Objective To observe the incidence and risk factors of postoperative pacemaker complications in elderly(>80 years)patients.Methods A total of 127 elderly patients implanted with cardiac pacemakers were selected from January 2014 to January 2018.The incidence of complications during a 60-day follow-up was observed.Multivariate logistic regression analysis was performed on related factors.Results Of the 127 patients,21(16.5%)had acute complications during follow-up.There was electrode dislocation(n=1,0.8%),pneumothorax(n=2,1.6%),local hematoma(n=9,71%),nerve injury(n=2,1.6%),subcutaneous emphysema(n=1,0.8%),venous thrombosis(n=1,0.8%),pericardial effusion(n=1,0.8%)and postoperative ventricular arrhythmia(n=4,3.1%).Multivariate logistic stepwise regression analysis showed that women,combined atrial fibrillation,and low body mass index(BMI)were statistically significant for the occurrence of acute complications(p<0.05).Conclusions The proportion of acute complications after permanent pacemaker implantation in elderly patients is 16.5%,and the related risk factors are women,atrial fibrillation,low BMI.It is necessary to strengthen the treatment and monitoring these patients.