Why do so few older people with aortic stenosis have valve replacement surgery?
Why do so few older people with aortic stenosis have valve replacement surgery?
复制标题
为什么患有主动脉瓣狭窄的老年人很少接受瓣膜置换手术？
DOI：
10.1093/ageing/28.3.261
复制
发表时间：
1999
期刊：
影响因子：
6.7
通讯作者：
G. Mulley
中科院分区：
文献类型：
--
作者：
A. Abdul;G. Mulley
背景
许多患有严重主动脉瓣狭窄的老年患者没有进行瓣膜置换手术。
目的
确定有症状的主动脉瓣狭窄老年人转诊接受专家评估的比例以及未转诊的原因。
方法
对一家英语教学医院老年科所有75岁以上患者的回顾性研究。通过审查所有超声心动图报告进行确认。
结果
在40名有症状的主动脉瓣狭窄患者中，只有4名接受了手术。7例拒绝手术;五人因健康原因不适合（并非心脏衰竭），而13人则未能找到不转介的理由。在15名转诊给心脏病专家的患者中，8名被认为适合手术。
结论
只有五分之一的75岁以上的超声心动图证实的主动脉瓣狭窄患者被认为是手术。前瞻性研究是必要的，以确定为什么病人和老年病学家不寻求专家评估这种可治疗的条件。
BACKGROUND
Many older patients with severe aortic stenosis do not have valve replacement surgery.
OBJECTIVE
To determine the proportion of older people with symptomatic aortic stenosis referred for specialist assessment and the reasons for non-referral.
METHODS
Retrospective study of all patients over 75 attending the geriatric department of an English teaching hospital. Confirmation was by reviewing all echocardiographic reports.
RESULTS
Of 40 patients with symptomatic aortic stenosis, only four had undergone surgery. Seven patients refused operation; five were medically unfit (for reasons other than heart failure) and reasons for not referring could not be found in 13 casenotes. Of the 15 patients referred to a cardiologist, eight were considered suitable for surgery.
CONCLUSION
Only one in five patients over 75 with echocardiographically-confirmed aortic stenosis was considered for surgery. Prospective studies are needed to determine why patients and geriatricians do not seek specialist assessment for this treatable condition.