Outcomes of noncardiac, nonobstetric surgery in patients with PAH: an international prospective survey
Outcomes of noncardiac, nonobstetric surgery in patients with PAH: an international prospective survey
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DOI：
10.1183/09031936.00089212
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发表时间：
2013-06-01
影响因子：
24.3
通讯作者：
Humbert, Marc
中科院分区：
文献类型：
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作者：
Meyer, Stephanie;McLaughlin, Vallerie V.;Humbert, Marc
我们在11个肺动脉高压中心进行了一项国际性、前瞻性、3年基于肺动脉高压的调查，收集了2007年7月至2010年6月期间接受非心脏和非产科手术的肺动脉高压（PAH）患者的数据，这些数据来自114例接受大手术的PAH患者（70%为女性，平均年龄57岁）。手术时，43%的患者为功能III/IV级。82%的干预是在全身麻醉下进行的，18%是在脊髓麻醉下进行的。7名患者（6.1%）发生严重并发症，其中4人死亡，导致围手术期总体死亡率为3.5%。急诊手术的死亡率为15%（2/13），而非急诊手术的死亡率为2%（2/101）（p=0.01）。主要并发症的风险因素是右心房压力升高（OR 1.1，95% CI 1.0-1.3; p=0.01），6分钟步行距离
We conducted an international, prospective, 3-year questionnaire-based survey among 11 pulmonary hypertension centres to assemble data from patients with pulmonary arterial hypertension (PAH) undergoing noncardiac and nonobstetric surgery.Data were collected between July 2007 and June 2010 from 114 patients with PAH (70% female, mean age 57 years) who underwent major surgery. At the time of surgery, 43% were in functional class III/IV. 82% of the interventions were performed under general anaesthesia and 18% under spinal anaesthesia. Major complications occurred in seven (6.1%) of the patients, of whom four died, resulting in an overall perioperative mortality rate of 3.5%. The mortality rate was 15% (two out of 13) in emergency procedures, compared with 2% (two out of 101) in nonemergency procedures (p=0.01). Risk factors for major complications were an elevated right atrial pressure (OR 1.1, 95% CI 1.0-1.3; p=0.01), a 6-min walking distance