目的:系统评价心脏植入式电子设备(CIED)植入术后设备感染(DRI)的风险预测模型。方法:通过计算机检索PubMed、Embase、Web of Science、Cochrane图书馆、CINAHL、中国生物医学文献数据库、中国知网、维普网、万方数据库中与CIED植入术后...目的:系统评价心脏植入式电子设备(CIED)植入术后设备感染(DRI)的风险预测模型。方法:通过计算机检索PubMed、Embase、Web of Science、Cochrane图书馆、CINAHL、中国生物医学文献数据库、中国知网、维普网、万方数据库中与CIED植入术后DRI风险预测模型相关的文献,检索时间为从建库至2023年12月2日。由2名研究者独立筛选文献、提取资料并完成纳入文献的偏倚风险与适用性评价。结果:共纳入16项研究,模型总体适用性较好,但偏倚风险较高,ROC曲线的AUC为0.67~0.96。11项研究完成了内部验证,5项研究进行了外部验证。囊袋和(或)电极重置/装置升级、肾功能不全或肾功能衰竭、年龄、植入埋藏式心脏复律除颤器或心脏再同步化治疗、使用抗凝药是DRI的预测因子。结论:目前CIED植入术后DRI风险预测模型整体性能较好,适用性较好,但偏倚风险较高。需在数据来源、变量筛选、模型评价等方面提高研究质量,开展前瞻性队列研究,完善现有模型的外部验证,并积极研发适用于我国人群的预测模型。展开更多
目的对心脏植入式电子设备植入术后术侧肢体出现的各种功能障碍的评估内容及早期功能锻炼进行范围综述,为未来早期识别不同的术侧肢体功能障碍和对术后进行早期康复锻炼指导提供参考。方法根据范围综述的研究方法,检索PubMed、Embase、C...目的对心脏植入式电子设备植入术后术侧肢体出现的各种功能障碍的评估内容及早期功能锻炼进行范围综述,为未来早期识别不同的术侧肢体功能障碍和对术后进行早期康复锻炼指导提供参考。方法根据范围综述的研究方法,检索PubMed、Embase、Cochrane Library、Web of Science、CINAHL、中国知网、维普数据库、万方数据库、中国生物医学文献数据库。检索时限为建库至2023年10月31日。对纳入文献进行分析和讨论。结果最终纳入15篇文献。包括随机对照试验7篇、队列研究6篇,病例对照研究2篇。心脏植入式电子设备植入术后术侧肢体相关功能障碍包括肩关节疼痛、肩关节活动范围受限(屈曲、外展、内外旋角度受限)、握力降低和肩胛骨运动障碍,肩关节疼痛和主动前屈受损发生率最高,分别达到61%和60%,主要是植入式心律转复除颤器(ICD)植入术后患者。评估工具包括主观工具和客观工具,评估肩关节疼痛的3种量表,评估肩关节活动范围的测角仪、评估握力的液压手测力仪、评估肩胛骨运动障碍的试验和卷尺、评估肩术侧肢体整体功能的5种量表。术侧肢体的各种相关功能障碍基本表现在术后2周时出现,术后3个月时开始好转,术后12个月时基本趋于正常,术后5年完全恢复,持续时间最长的是ICD植入患者;康复运动方案包括5种,其中钟摆运动是单一方案,其余4种均是综合康复运动方案,均有成效;干预时间点有术后1~2 d,术后1周,术后2周。结论心脏植入式电子设备植入术后需要重点关注术侧肢体存在的系列相关功能障碍,评估工具多样化,应根据测量重点进行合适选择;虽然都有自限性,但自愈时间还是比较长,术后1年内在门诊定期复诊时需要纳入筛查,对其进行综合性干预;患者进行综合功能锻炼方案有利于降低术侧肢体不同功能障碍的发生率,缩短功能障碍的时间,具有进一步在临床推广应用的价值,但锻炼方案不统一,还需要进一步验证哪一类活动方案或者综合某几类活动方案进一步研究;早期功能锻炼时间不统一,有待进一步确定。展开更多
Background Cardiac implantable electronic devices （CIEDs） greatly improve survival and life quality of patients. However, there are gender differences regarding both the utilization and benefit of these devices. In ...Background Cardiac implantable electronic devices （CIEDs） greatly improve survival and life quality of patients. However, there are gender differences regarding both the utilization and benefit of these devices. In this prospective CIED registry, we aim to appraise the gender differences in CIED utilization in China. Methods Twenty centers from 14 provinces in China were included in our registry study. All patients who underwent a CIED implantation in these twenty centers between Jan 2015 and Dec 2016 were included. Results A total of 8570 patients were enrolled in the baseline cohort, including 7203 pacemaker, 664 implantable cardiac defibrillators （ICD） implants and 703 cardiac resynchronization therapy device （CRT/D）. Totally, 4117 （48.0%） CIED patients were female, and more than 59% pacemaker patients were female, but women account only one third of ICD or CRT/D implantation in this registry. There were significant differences between genders at pacemaker and ICD indications. Female was more likely received a pacemaker due to sick sinus syndrome （SSS） （63.9% vs. 51.0%, P 〈 0.001）. Female patients receiving an ICD were more likely due to cardiac ion channel disease （29.2% vs. 4.2%, P 〈 0.001）. The percentage of utilization of dual-chamber pacemaker in female patients was significantly higher than male （85.3% vs. 81.1%, P 〈 0.001）. But male patients were more likely received a cardiac resynchronization therapy devices with defibrillator than female （56.5% vs. 41.9%, P = 0.001）. In pacemaker patient, male was more likely to have structure heart disease （31.3% vs. 28.0%, P = 0.002）. In ICD patient, male patients were more likely to have ischemic heart disease （48.2% vs. 29.2%, P 〈 0.001）. The mean age of women at the time of CRT/D implantation was older than men （P = 0.014）. Nonischemic cardiomyopathy （70.9%） was the most common etiology in the patients who underwent the treat？ment of CRT/D, no matter male or female. Conclusions In real-world setting, female do have different epidemiology, pathophysiology and clinical presentation of many cardiac rhythm disorders when compared with male, and all these factors may affect the utilization of CIED implantation. But it also possibility that cultural and socioeconomic features may play a role in this apparent discrimination.展开更多
We read with interest the article by Olechowski, et aL recently published in the Journal of Geriatric Cardiology. The results of this retrospective analysis of patients under- going cardiac resynchronization therapy ...We read with interest the article by Olechowski, et aL recently published in the Journal of Geriatric Cardiology. The results of this retrospective analysis of patients under- going cardiac resynchronization therapy （CRT） device implantation are in line with previous reports, suggesting that resynchronization therapy in the elderly is feasible and may lead to significant improvement of cardiac function and clinical status.展开更多
文摘目的:系统评价心脏植入式电子设备(CIED)植入术后设备感染(DRI)的风险预测模型。方法:通过计算机检索PubMed、Embase、Web of Science、Cochrane图书馆、CINAHL、中国生物医学文献数据库、中国知网、维普网、万方数据库中与CIED植入术后DRI风险预测模型相关的文献,检索时间为从建库至2023年12月2日。由2名研究者独立筛选文献、提取资料并完成纳入文献的偏倚风险与适用性评价。结果:共纳入16项研究,模型总体适用性较好,但偏倚风险较高,ROC曲线的AUC为0.67~0.96。11项研究完成了内部验证,5项研究进行了外部验证。囊袋和(或)电极重置/装置升级、肾功能不全或肾功能衰竭、年龄、植入埋藏式心脏复律除颤器或心脏再同步化治疗、使用抗凝药是DRI的预测因子。结论:目前CIED植入术后DRI风险预测模型整体性能较好,适用性较好,但偏倚风险较高。需在数据来源、变量筛选、模型评价等方面提高研究质量,开展前瞻性队列研究,完善现有模型的外部验证,并积极研发适用于我国人群的预测模型。
文摘目的对心脏植入式电子设备植入术后术侧肢体出现的各种功能障碍的评估内容及早期功能锻炼进行范围综述,为未来早期识别不同的术侧肢体功能障碍和对术后进行早期康复锻炼指导提供参考。方法根据范围综述的研究方法,检索PubMed、Embase、Cochrane Library、Web of Science、CINAHL、中国知网、维普数据库、万方数据库、中国生物医学文献数据库。检索时限为建库至2023年10月31日。对纳入文献进行分析和讨论。结果最终纳入15篇文献。包括随机对照试验7篇、队列研究6篇,病例对照研究2篇。心脏植入式电子设备植入术后术侧肢体相关功能障碍包括肩关节疼痛、肩关节活动范围受限(屈曲、外展、内外旋角度受限)、握力降低和肩胛骨运动障碍,肩关节疼痛和主动前屈受损发生率最高,分别达到61%和60%,主要是植入式心律转复除颤器(ICD)植入术后患者。评估工具包括主观工具和客观工具,评估肩关节疼痛的3种量表,评估肩关节活动范围的测角仪、评估握力的液压手测力仪、评估肩胛骨运动障碍的试验和卷尺、评估肩术侧肢体整体功能的5种量表。术侧肢体的各种相关功能障碍基本表现在术后2周时出现,术后3个月时开始好转,术后12个月时基本趋于正常,术后5年完全恢复,持续时间最长的是ICD植入患者;康复运动方案包括5种,其中钟摆运动是单一方案,其余4种均是综合康复运动方案,均有成效;干预时间点有术后1~2 d,术后1周,术后2周。结论心脏植入式电子设备植入术后需要重点关注术侧肢体存在的系列相关功能障碍,评估工具多样化,应根据测量重点进行合适选择;虽然都有自限性,但自愈时间还是比较长,术后1年内在门诊定期复诊时需要纳入筛查,对其进行综合性干预;患者进行综合功能锻炼方案有利于降低术侧肢体不同功能障碍的发生率,缩短功能障碍的时间,具有进一步在临床推广应用的价值,但锻炼方案不统一,还需要进一步验证哪一类活动方案或者综合某几类活动方案进一步研究;早期功能锻炼时间不统一,有待进一步确定。
文摘Background Cardiac implantable electronic devices （CIEDs） greatly improve survival and life quality of patients. However, there are gender differences regarding both the utilization and benefit of these devices. In this prospective CIED registry, we aim to appraise the gender differences in CIED utilization in China. Methods Twenty centers from 14 provinces in China were included in our registry study. All patients who underwent a CIED implantation in these twenty centers between Jan 2015 and Dec 2016 were included. Results A total of 8570 patients were enrolled in the baseline cohort, including 7203 pacemaker, 664 implantable cardiac defibrillators （ICD） implants and 703 cardiac resynchronization therapy device （CRT/D）. Totally, 4117 （48.0%） CIED patients were female, and more than 59% pacemaker patients were female, but women account only one third of ICD or CRT/D implantation in this registry. There were significant differences between genders at pacemaker and ICD indications. Female was more likely received a pacemaker due to sick sinus syndrome （SSS） （63.9% vs. 51.0%, P 〈 0.001）. Female patients receiving an ICD were more likely due to cardiac ion channel disease （29.2% vs. 4.2%, P 〈 0.001）. The percentage of utilization of dual-chamber pacemaker in female patients was significantly higher than male （85.3% vs. 81.1%, P 〈 0.001）. But male patients were more likely received a cardiac resynchronization therapy devices with defibrillator than female （56.5% vs. 41.9%, P = 0.001）. In pacemaker patient, male was more likely to have structure heart disease （31.3% vs. 28.0%, P = 0.002）. In ICD patient, male patients were more likely to have ischemic heart disease （48.2% vs. 29.2%, P 〈 0.001）. The mean age of women at the time of CRT/D implantation was older than men （P = 0.014）. Nonischemic cardiomyopathy （70.9%） was the most common etiology in the patients who underwent the treat？ment of CRT/D, no matter male or female. Conclusions In real-world setting, female do have different epidemiology, pathophysiology and clinical presentation of many cardiac rhythm disorders when compared with male, and all these factors may affect the utilization of CIED implantation. But it also possibility that cultural and socioeconomic features may play a role in this apparent discrimination.
文摘We read with interest the article by Olechowski, et aL recently published in the Journal of Geriatric Cardiology. The results of this retrospective analysis of patients under- going cardiac resynchronization therapy （CRT） device implantation are in line with previous reports, suggesting that resynchronization therapy in the elderly is feasible and may lead to significant improvement of cardiac function and clinical status.
