Age- and sex-related differences in risk factors for perioperative intra-aortic balloon pump application in patients undergoing coronary artery bypass grafting

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2024-09-03 DOI:10.3389/fsurg.2024.1395518

Junyi Gao, Qing Zhao, Yi Cheng

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引用次数: 0

Abstract

BackgroundAn intra-aortic balloon pump (IABP) is a mechanical circulatory device frequently used in patients undergoing coronary artery bypass grafting (CABG). As a treatment for perioperative haemodynamic instability, IABP insertion often implicates an adverse outcome. This study aimed to investigate the age- and sex-related disparity in risk factors for perioperative IABP insertion in CABG patients.MethodsA total of 2,460 CABG patients were included and divided into subgroups by age (elderly subgroup, ≥65 years; young subgroup, <65 years) and sex. Basic characteristics were compared between IABP and non-IABP patients in the overall patient group and the subgroups. Multivariate logistic analysis was used to investigate the significant risk factors for perioperative IABP application, and interaction effects among the potential risk factors were analysed. Combined receiver operating characteristic analysis was used to evaluate the prediction value of combined risk factors.ResultsThe overall patient group had a mean age of 61.5 years. The application rate of perioperative IABP was 8.0%. A left ventricular ejection fraction (LVEF) <50% significantly correlated with perioperative IABP application in the overall patient group and the subgroups. Traditional factors such as myocardial infarction history, atrial fibrillation history, and intraoperative estimated blood loss were significant risk factors in certain subgroups. Small dense low-density lipoprotein levels were significantly associated with IABP insertion in the male subgroup and young subgroup. The area under the curve of combined risk factors was significantly higher than that of LVEF <50% alone in the overall patient group and subgroups.ConclusionAge- and sex-related differences were present in the risk factor distribution for perioperative IABP insertion in CABG patients.

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冠状动脉旁路移植术患者围手术期主动脉内球囊泵应用风险因素的年龄和性别差异

背景主动脉内球囊反搏泵（IABP）是一种机械循环装置，常用于接受冠状动脉旁路移植术（CABG）的患者。作为围手术期血流动力学不稳定的一种治疗方法，IABP 的插入往往会带来不良后果。本研究旨在调查 CABG 患者围术期插入 IABP 的风险因素与年龄和性别的差异。方法共纳入 2,460 例 CABG 患者，并按年龄（老年亚组，≥65 岁；年轻亚组，<65 岁）和性别分为若干亚组。比较了患者总体组和亚组中 IABP 和非 IABP 患者的基本特征。采用多变量逻辑分析法研究了围手术期应用 IABP 的重要风险因素，并分析了潜在风险因素之间的交互效应。结果整组患者的平均年龄为 61.5 岁。围手术期IABP应用率为8.0%。左心室射血分数（LVEF）<50%与围手术期IABP的应用有显著相关性。心肌梗死史、心房颤动史和术中估计失血量等传统因素是某些亚组的重要风险因素。在男性亚组和年轻亚组中，小密度低密度脂蛋白水平与植入 IABP 明显相关。结论 CABG 患者围术期插入 IABP 的风险因素分布存在年龄和性别差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.