首页 > 重症医学词汇大全 > Congenital heart disease
Improved Outcomes of Heart Transplantation in Adults With Congenital Heart Disease Receiving Regionalized Care.
接受区域化护理的成人先天性心脏病患者心脏移植的改善结果。
Adult Congenital Heart Association United Network of Organ Sharing adult congenital heart disease center heart transplantation
下载

摘要

BACKGROUND:The number of adult congenital heart disease (CHD) patients undergoing heart transplantation is increasing rapidly. CHD patients have higher surgical risk at transplantation. High-volume adult CHD transplant centers may have better transplant outcomes.
OBJECTIVES:This study aimed to evaluate the effect of center CHD transplant volume and expertise on transplant outcomes in CHD patients.
METHODS:The authors studied heart transplantations in CHD patients age ≥18 years using the United Network of Organ Sharing (UNOS) database for the primary outcomes of waitlist mortality and post-transplant outcomes at 30 days and 1 year. Transplant centers were assessed by status as the highest CHD transplant volume center in a UNOS region versus all others, presence of Adult Congenital Heart Association accreditation, and adult versus pediatric hospital designation.
RESULTS:Between January of 2000 and June of 2018, 1,746 adult CHD patients were listed for transplant; 1,006 (57.6%) of these underwent heart transplantation. After adjusting for age, sex, listing status, and inotrope requirement, waitlist mortality risk was lower at Adult Congenital Heart Association accredited centers (hazard ratio: 0.730; p = 0.020). Post-transplant 30-day mortality was lower at the highest volume CHD transplant center in each UNOS region (hazard ratio: 0.706; p = 0.014).
CONCLUSIONS:Designated expertise in CHD care is associated with improved waitlist outcomes for CHD patients listed for transplantation. Post-transplant survival was improved at the highest volume regional center. These findings suggest a possible advantage of regionalization of CHD transplantation.

译文

背景: 接受心脏移植的成人先天性心脏病患者数量正在迅速增加。冠心病患者在移植时有较高的手术风险。大量成人冠心病移植中心可能有更好的移植结果。
目的: 本研究旨在评估中心冠心病移植体积和专业知识对冠心病患者移植结果的影响。
方法: 作者使用器官共享联合网络 (UNOS) 研究了年龄 ≥ 18 岁的冠心病患者的心脏移植等待名单死亡率和移植后 30 天和 1 年结果的主要结果数据库。移植中心被评估为 UNOS 地区与所有其他地区相比最高的冠心病移植量中心,成人先天性心脏协会认证,成人与儿科医院指定。
结果: 1月至 2000年和 6月 2018年 1,746 犬 CHD 患者移植名单; 1,006 (57.6% mm) 的接受心脏移植。在调整了年龄、性别、列表状态和肌力要求后,成人先天性心脏病协会认证中心的等待名单死亡风险较低 (危险比: 0.730; p = 0.020)。移植后 30 天死亡率在每个 UNOS 地区的最高容量的冠心病移植中心较低 (风险比: 0.706; p = 0.014)。
结论: 冠心病护理的指定专业知识与被列为移植的冠心病患者的等待名单结果的改善有关。移植后的存活率在最高容量的区域中心得到了提高。这些发现表明了冠心病移植区域化的可能优势。

Congenital heart disease

重症 先天性心脏病 疾病
概述  :  

先天性心脏病(congenital heart disease, CHD),简称先心病,是胎儿期心脏及大血管发育异常所致的先天性畸形,是小儿最常见的心脏病,也是婴幼儿死亡的主要原因之一。流行病学调查资料提示,先心病的发病率占全部活产婴儿的6‰~10‰。根据目前的研究进展,先心病是由遗传因素、环境因素单独作用或两者共同作用所致,其中由遗传及环境因素共同作用所致的先心病占总数的75%~90%。   病理机制 1.心脏不发育 若

congenital 英 [kənˈdʒenɪtl] 美 [kənˈdʒenɪtl]

释义   adj. 先天的,天生的;天赋的

例句   We suspect he also had a partially cleft palate, another congenital defect.我们怀疑他还有部分腭裂,这也是一种先天性缺陷。

 

heart 英 [hɑːt] 美 [hɑːrt]

释义   n. 心脏;感情;勇气;心形;要点

vt. 鼓励;铭记

vi. 结心

n. (Heart)人名;(英)哈特

例句   His heart is beating violently in his breast.他的心在胸膛里激烈地跳动。

 

disease 英 [dɪˈziːz] 美 [dɪˈziːz]

释义   n. 病,[医] 疾病;弊病

vt. 传染;使…有病

例句   The disease is quickly spreading in the world.这种疾病正在迅速地向世界各地蔓延。

请扫描右侧二维码,免费查看词汇专业知识背景