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80岁以上老人接受植入式除颤器后的生存率分析
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作者 Koplan B.A. epstein l.m. +2 位作者 Albert C.M. Stevenson W.G. 朱冰坡 《世界核心医学期刊文摘(心脏病学分册)》 2007年第3期20-21,共2页
背景:尽管许多临床试验已经扩展了植入式除颤器(ICD)的适应证,但是在这些研究中很少入选80岁以上的老人。总之,该亚组的生存率尚不明确。方法:对1995年7月和2003年9月之间接受ICD植入且当时年龄≥80岁的患者进行了回顾性分析。
关键词 植入式 临床试验 中位生存时间 生存分析 亚组 射血分数 存活时间 植入者 组植 肾小球滤过率
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预测埋藏式除颤器植入后的早期死亡率:选择患者的最佳临床风险评分
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作者 Parkash R. Stevenson W.G. +2 位作者 epstein l.m. Maisel W.H. 宁宁 《世界核心医学期刊文摘(心脏病学分册)》 2006年第6期15-15,共1页
Background: Patients with advanced heart disease are at risk from sudden death; however, benefit from implantable cardioverter defibrillators(ICDs) may be limited as a result of early mortality from other causes. The ... Background: Patients with advanced heart disease are at risk from sudden death; however, benefit from implantable cardioverter defibrillators(ICDs) may be limited as a result of early mortality from other causes. The objective of this study was to develop a model to predict mortality within the first year after ICD implantation. Methods and Results: A retrospective analysis was performed of 469 consecutive patients who underwent ICD implantation at a single tertiary- care center from 1999 to 2002. Vital status was determined from the Social Security Death Index. Patients were randomized into prediction and validation cohorts. A risk score was derived from the prediction cohort by multivariate logistic regression and applied to the validation cohort. One point was assigned for each variable in the risk score(age>80 years, history of atrial fibrillation, creatinine> 1.8 mg/dL,New York Heart Association class III or IV). One- year mortality significantly increased with increasing risk score in both the prediction and validation cohorts. Validation cohort mortality was 3.4% for 0 points, 4.3% for 1 point, 17% for 2 points, and 33% for ≥ 3 points(P for trend< .0001). A risk score ≥ 2 predicted a 1- year mortality rate of 21% , whereas a risk score< 2 predicted a mortality rate of 4% at 1 year(P< .0001). Conclusion: A risk score using simple clinical criteria may identify patients at high risk of early mortality after ICD implantation. This may be helpful in consideration of ICD risk/benefit for individual patients. Further studies conducted in a prospective manner using these clinical criteria are warranted. 展开更多
关键词 心脏病患者 埋藏式除颤器 早期死亡率 植入后 评分 风险 预测 logistic回归法 临床 三级医疗中心
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