经皮冠状动脉介入治疗术后早期再入院危险因素的荟萃分析

Risk factors for early readmission after percutaneous coronary intervention:a meta-analysis

目的 探讨经皮冠状动脉介入治疗(PCI)术后患者早期再入院的危险因素。方法 计算机检索PubMed、the Cochrane Library、Embase、Web of science、中国知网、中国生物医学文献数据库、万方、维普数据中关于PCI术后早期再入院危险因素的队列研究或病例对照研究。检索时限为建库至2021年7月13日。利用RenMan 5.3软件进行分析。结果 共纳入12篇文献,包括23项危险因素,结果显示有统计学意义的危险因素为年龄>65岁(OR=1.39,95%CI:1.21~1.59)、女性(OR=1.29,95%CI:1.24~1.33)、左室射血分数(OR=1.27,95%CI:1.17~1.37)、多支血管病变(OR=2.97,95%CI:2.00~4.41)、外周血管疾病(OR=1.44,95%CI:1.30~1.59)、慢性肺部疾病(OR=1.31,95%CI:1.22~1.40)、糖尿病(OR=1.23,95%CI:1.18~1.28)、肾功能不全(OR=1.37,95%CI:1.27~1.48)、卒中/短暂性脑缺血发作(OR=1.32,95%CI:1.07~1.62)、住院时间(OR=1.41,95%CI:1.00~1.98)、高血压(OR=1.12,95%CI:1.09~1.15)、心力衰竭(OR=1.40,95%CI:1.30~1.51)、贫血(OR=1.25,95%CI:1.13~1.37)和医疗保险(OR=1.19,95%CI:1.03~1.37)。结论 现有证据表明,年龄>65岁、女性、左室射血分数、多支血管病变、外周血管疾病、慢性肺部疾病、糖尿病、肾功能不全、卒中/短暂性脑缺血发作、住院时间、高血压、心力衰竭、贫血和医疗保险是PCI术后早期再入院的危险因素。

Objective To investigate the risk factors for early re-admission of patients after percutaneous coronary intervention(PCI).Methods We used computer to search the PubMed,The Cochrane Library,Embase,Web of science,CNKI,China Biomedical Literature Database,Wanfang,and Weipu data for cohort studies or case-control studies on the risk factors of early readmission after PCI.The retrieval time limit was from the establishment of the database to July 13,2021.Meta-analysis was performed using RenMan 5.3 software.Results A total of 12 articles were included,including 23 risk factors.Meta-analysis showed that the statistically significant risk factors were over 65 years old(OR=1.39,95%CI:1.21-1.59),women(OR=1.29,95%CI:1.24-1.33),left ventricular ejection fraction(OR=1.27,95%CI:1.17-1.37),multivessel disease(OR=2.97,95%CI:2.00-4.41),peripheral vascular disease(OR=1.44,95%CI:1.30-1.59),chronic lung disease(OR=1.31,95%CI:1.22-1.40),diabetes mellitus(OR=1.23,95%CI:1.18-1.28),renal insufficiency(OR=1.37,95%CI:1.27-1.48),stroke/transient ischemic attack(OR=1.32,95%CI:1.07-1.62),length of hospital stay(OR=1.41,95%CI:1.00-1.98),hypertension(OR=1.12,95%CI:1.09-1.15),heart failure(OR=1.40,95%CI:1.30-1.51),anemia(OR=1.25,95%CI:1.13-1.37) and medical insurance(OR=1.19,95%CI:1.03-1.37).Conclusions The existing evidences show that age >65 years,female,left ventricular ejection fraction,multivessel disease,peripheral vascular disease,chronic lung disease,diabetes,renal insufficiency,stroke/transient ischemic attack,length of hospital stay,hypertension,heart failure,anemia and medical insurance are risk factors for early readmission after PCI.