Survival analysis and risk factors for mortality in transplantation and staged surgery for hypoplastic left heart syndrome
Survival analysis and risk factors for mortality in transplantation and staged surgery for hypoplastic left heart syndrome
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DOI：
10.1016/s0735-1097(00)00855-x
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发表时间：
2000-10-01
影响因子：
24
通讯作者：
O'Connor, GT
中科院分区：
文献类型：
--
作者：
Jenkins, PC;Flanagan, MF;O'Connor, GT
我们比较了治疗策略的生存率，并使用意向治疗分析确定了左心发育不良综合征（HLHS）一年死亡率的危险因素。背景在治疗接受分析中比较了自体心脏和移植作为HLHS治疗的分期翻修，这可能会导致结果偏倚。出生于1989年至1994年，并打算手术，收集了四个小儿心脏外科中心。状态在最后一次接触的生存分析和死亡率在一年的危险因素analysiswere outcome measurements.RESULTS生存曲线显示，预期移植的患者比预期分期手术的患者生存率提高。移植组和分期手术组的1年生存率分别为61%和42%（p < 0.01）; 5年生存率分别为55%和38%（p < 0.01）。经术前差异校正的生存曲线也有显著差异（p < 0.001）。等待名单死亡率占移植组第一年死亡率的63%。第一阶段手术的死亡率占该策略首次手术死亡率的86%。出生体重
OBJECTIVES We compared survival in treatment strategies and determined risk factors for one-year mortality for hypoplastic left heart syndrome (HLHS) using intention-to-treat analysis.BACKGROUND Staged revision of the native heart and transplantation as treatments for HLHS have been compared in treatment-received analyses, which can bias results.METHODS Data on 231 infants with HLHS, born between 1989 and 1994 and intended for surgery, were collected from four pediatric cardiac surgical centers. Status at last contact for survival analysis and mortality at one year for risk factor analysis were the outcome measures.RESULTS Survival curves showed improved survival for patients intended for transplantation over patients intended for staged surgery. One-year survival was 61% for transplantation and 42% for staged surgery (p < 0.01); five-year survival was 55% and 38%, respectively (p < 0.01). Survival curves adjusted for preoperative differences were also significantly different (p < 0.001). Waiting-list mortality accounted for 63% of first-year deaths in the transplantation group. Mortality with stage 1 surgery accounted for 86% of that strategy's first-pear mortality. Birth weight