主动脉夹层患者假性管腔血栓形成是否能带来更好的结果：荟萃分析和系统评价。

IF 0.7 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart Surgery Forum Pub Date : 2023-10-30 DOI:10.59958/hsf.5739

Shiming Zhang, Wei Sun, Shidong Liu, Bing Song, Lili Xie, Ruisheng Liu

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引用次数: 0

摘要

目的：长期以来，主动脉夹层患者的假腔状态与预后之间的关系一直不清楚，因此本文旨在研究假腔的通畅与主动脉夹层患者预后是否相关。方法：我们根据2009年系统评价和荟萃分析方案的首选报告项目（PRISMA）声明进行了系统评价和元分析，并在PROSPERO注册（CRD42022381869）。我们搜索了PubMed、Cochrane图书馆、Web of Science和Embase以收集潜在的研究。纽卡斯尔-渥太华量表用于评估纳入研究的质量。主要结果是长期生存。研究中包含的数据使用风险比或平均差和95%置信区间进行总结。结果：共有16项试验，2829名患者，平均年龄62.1岁。与完全血栓形成的假腔相比，专利组具有更好的长期生存率（风险比（RR），0.88；95%可信区间为0.79～0.97；p＝0.01；I2=58%）和较小的主动脉年生长率（平均差（MD），1.03；95%可信区间0.23-1.82；p＝0.01；I2=98%）。此外，管腔未闭的患者发生主动脉事件的风险较低（RR，0.81；95%CI，0.68至0.97；p=0.02；I2=37%），但主动脉破裂（RR，7.02；95%可信区间，2.55至19.3；p=0.0002；I2=0）和住院死亡（RR，2.72；95%置信区间，1.45至5.08；p=0.002；I2=0。未闭假腔患者发生主动脉破裂和住院死亡的风险是完全血栓形成假腔患者的7倍和3倍。它有望根据不同的假腔状态为不同类型的患者提供个性化的医疗护理，以最大限度地减少死亡和相关并发症。

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Does False Lumen Thrombosis Lead to Better Outcomes in Patients with Aortic Dissection: A Meta-Analysis and Systematic Review.

Objectives: For a long time, the association of the false lumen status and the outcomes of patients suffering from aortic dissection has been unclear, so this review article aims to study whether the unobstructed of the false lumen is related to the outcome of patients suffering from aortic dissection.

Methods: We performed this systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta Analyzes Protocols (PRISMA) statement 2009 and registered with PROSPERO (CRD42022381869). We searched PubMed, the Cochrane library, Web of Science and Embase to collect potential studies. The Newcastle-Ottawa Scale was used to assess the quality of the included studies. The main outcome is long-term survival. Data included in the study were summarized using the risk ratio or mean difference and 95% confidence interval.

Results: There were 16 trials, 2829 patients in total, with a mean age of 62.1 years. Compared with completely thrombosed false lumen, patent group has better long-term survival (risk ratio (RR), 0.88; 95% CI, 0.79 to 0.97; p = 0.01; I2 = 58%) and smaller yearly aortic growth rate (mean difference (MD), 1.03; 95% CI, 0.23 to 1.82; p = 0.01; I2 = 98%). In addition, patients with a patent false lumen had a lower risk of aortic event (RR, 0.81; 95% CI, 0.68 to 0.97; p = 0.02; I2 = 37%), but higher risk of aortic rupture (RR, 7.02; 95% CI, 2.55 to 19.3; p = 0.0002; I2 = 0) and hospital death (RR, 2.72; 95% CI, 1.45 to 5.08; p = 0.002; I2 = 0).

Conclusion: Completely thrombosed of the false lumen is more beneficial to the long-term survival of patients with aortic dissection. And the risk of aortic rupture and hospital death in patients with patent false lumen is 7 times and 3 times that of patients with complete thrombosed false lumen. It is expected to provide individualized medical care for different types of patients according to different false lumen status to minimize death and related complications.

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来源期刊

Heart Surgery Forum 医学-外科

CiteScore

1.20

自引率

16.70%

发文量

130

审稿时长

6-12 weeks

期刊介绍： The Heart Surgery Forum® is an international peer-reviewed, open access journal seeking original investigative and clinical work on any subject germane to the science or practice of modern cardiac care. The HSF publishes original scientific reports, collective reviews, case reports, editorials, and letters to the editor. New manuscripts are reviewed by reviewers for originality, content, relevancy and adherence to scientific principles in a double-blind process. The HSF features a streamlined submission and peer review process with an anticipated completion time of 30 to 60 days from the date of receipt of the original manuscript. Authors are encouraged to submit full color images and video that will be included in the web version of the journal at no charge.