Sehnaz Olgun Yildizeli, Hüseyin Arıkan, Sinem Güngör, Aslı Tufan, Derya Kocakaya, Halil Ataş, Bülent Mutlu, Serpil Tas, Koray Ak, G Nural Bekiroğlu, Bedrettin Yildizeli
{"title":"肺动脉内膜切除术:早期和晚期死亡率的风险因素。","authors":"Sehnaz Olgun Yildizeli, Hüseyin Arıkan, Sinem Güngör, Aslı Tufan, Derya Kocakaya, Halil Ataş, Bülent Mutlu, Serpil Tas, Koray Ak, G Nural Bekiroğlu, Bedrettin Yildizeli","doi":"10.1055/a-2409-5944","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong> Pulmonary endarterectomy (PEA) is a potentially curative treatment option for chronic thromboembolic pulmonary hypertension (CTEPH). This study aimed to identify predictors of short- and long-term outcomes after PEA for CTEPH patients, including age.</p><p><strong>Methods: </strong> Patients who underwent surgery between March 2014 and January 2024 were included in the study. Perioperative and follow-up data were retrospectively studied, including age, in-hospital mortality, 1- and 5-year survival, and the length of intensive care unit (ICU) and hospital stays after PEA.</p><p><strong>Results: </strong> In total, 834 consecutive patients (mean age 51 ± 15.3 years) underwent PEA and were included in the analysis. The in-hospital mortality rate was 7.8% (<i>n</i> = 65), while overall mortality rates at 1 and 5 years were 10.6% and 11.3%, respectively. The in-hospital mortality rate was 6.7% for patients <70 years compared with 12.4% for patients ≥70 years (<i>p</i> = 0.029). In the multivariate analysis of mortality, age (<i>p</i> = 0.007), and length of ICU stay (<i>p</i> = 0.028) emerged as independent predictors of in-hospital mortality, while the Charlson Comorbidity Index (<i>p</i> < 0.001) and 6-minute walk distance (<i>p</i> = 0.005) were also significant predictors of 1-year survival.</p><p><strong>Conclusion: </strong> Despite higher short-term mortality rates, PEA was feasible and well-tolerated among elderly patients. Despite surgical advancements, careful patient selection remains crucial, particularly in the presence of comorbidities. Significant clinical and hemodynamic improvements were observed, along with favorable long-term survival outcomes.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"230-236"},"PeriodicalIF":1.3000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961224/pdf/","citationCount":"0","resultStr":"{\"title\":\"Pulmonary Endarterectomy: Risk Factors for Early and Late Mortality.\",\"authors\":\"Sehnaz Olgun Yildizeli, Hüseyin Arıkan, Sinem Güngör, Aslı Tufan, Derya Kocakaya, Halil Ataş, Bülent Mutlu, Serpil Tas, Koray Ak, G Nural Bekiroğlu, Bedrettin Yildizeli\",\"doi\":\"10.1055/a-2409-5944\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong> Pulmonary endarterectomy (PEA) is a potentially curative treatment option for chronic thromboembolic pulmonary hypertension (CTEPH). This study aimed to identify predictors of short- and long-term outcomes after PEA for CTEPH patients, including age.</p><p><strong>Methods: </strong> Patients who underwent surgery between March 2014 and January 2024 were included in the study. Perioperative and follow-up data were retrospectively studied, including age, in-hospital mortality, 1- and 5-year survival, and the length of intensive care unit (ICU) and hospital stays after PEA.</p><p><strong>Results: </strong> In total, 834 consecutive patients (mean age 51 ± 15.3 years) underwent PEA and were included in the analysis. The in-hospital mortality rate was 7.8% (<i>n</i> = 65), while overall mortality rates at 1 and 5 years were 10.6% and 11.3%, respectively. The in-hospital mortality rate was 6.7% for patients <70 years compared with 12.4% for patients ≥70 years (<i>p</i> = 0.029). In the multivariate analysis of mortality, age (<i>p</i> = 0.007), and length of ICU stay (<i>p</i> = 0.028) emerged as independent predictors of in-hospital mortality, while the Charlson Comorbidity Index (<i>p</i> < 0.001) and 6-minute walk distance (<i>p</i> = 0.005) were also significant predictors of 1-year survival.</p><p><strong>Conclusion: </strong> Despite higher short-term mortality rates, PEA was feasible and well-tolerated among elderly patients. Despite surgical advancements, careful patient selection remains crucial, particularly in the presence of comorbidities. Significant clinical and hemodynamic improvements were observed, along with favorable long-term survival outcomes.</p>\",\"PeriodicalId\":23057,\"journal\":{\"name\":\"Thoracic and Cardiovascular Surgeon\",\"volume\":\" \",\"pages\":\"230-236\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961224/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Thoracic and Cardiovascular Surgeon\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/a-2409-5944\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/4 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Thoracic and Cardiovascular Surgeon","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2409-5944","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/4 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Pulmonary Endarterectomy: Risk Factors for Early and Late Mortality.
Background: Pulmonary endarterectomy (PEA) is a potentially curative treatment option for chronic thromboembolic pulmonary hypertension (CTEPH). This study aimed to identify predictors of short- and long-term outcomes after PEA for CTEPH patients, including age.
Methods: Patients who underwent surgery between March 2014 and January 2024 were included in the study. Perioperative and follow-up data were retrospectively studied, including age, in-hospital mortality, 1- and 5-year survival, and the length of intensive care unit (ICU) and hospital stays after PEA.
Results: In total, 834 consecutive patients (mean age 51 ± 15.3 years) underwent PEA and were included in the analysis. The in-hospital mortality rate was 7.8% (n = 65), while overall mortality rates at 1 and 5 years were 10.6% and 11.3%, respectively. The in-hospital mortality rate was 6.7% for patients <70 years compared with 12.4% for patients ≥70 years (p = 0.029). In the multivariate analysis of mortality, age (p = 0.007), and length of ICU stay (p = 0.028) emerged as independent predictors of in-hospital mortality, while the Charlson Comorbidity Index (p < 0.001) and 6-minute walk distance (p = 0.005) were also significant predictors of 1-year survival.
Conclusion: Despite higher short-term mortality rates, PEA was feasible and well-tolerated among elderly patients. Despite surgical advancements, careful patient selection remains crucial, particularly in the presence of comorbidities. Significant clinical and hemodynamic improvements were observed, along with favorable long-term survival outcomes.
期刊介绍:
The Thoracic and Cardiovascular Surgeon publishes articles of the highest standard from internationally recognized thoracic and cardiovascular surgeons, cardiologists, anesthesiologists, physiologists, and pathologists. This journal is an essential resource for anyone working in this field.
Original articles, short communications, reviews and important meeting announcements keep you abreast of key clinical advances, as well as providing the theoretical background of cardiovascular and thoracic surgery. Case reports are published in our Open Access companion journal The Thoracic and Cardiovascular Surgeon Reports.