The European Registry for Patients with Mechanical Circulatory Support (EUROMACS): fourth Paediatric EUROMACS (Paedi-EUROMACS) report.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Rohde Sofie, van Puyvelde Joeri, Veen Kevin M, Schweiger Martin, Biermann Daniel, Amodeo Antonio, Martens Thomas, Damman Kevin, Gollmann-Tepeköylü Can, Hulman Michael, Iacovoni Attilio, Krämer Ulrike S, Loforte Antonio, Pace Napoleone Carlo, Nemec Petr, Netuka Ivan, Özbaran Mustafa, Polo Luz, Pya Yuriy, Ramjankhan Faiz, Sandica Eugen, Sliwka Joanna, Stiller Brigitte, Kadner Alexander, Franceschini Alessio, Thiruchelvam Timothy, Zimpfer Daniel, Berger Felix, Davies Ben, Dashkevich Alexey, Stark Christoffer, Meyns Bart, de By Theo M M H, Miera Oliver
Аннотация
METHODS: All paediatric (<19 years) patients from the EUROMACS database supported by a VAD were included. Patients were stratified into a congenital heart disease (CHD) group and a group with a non-congenital aetiology. End points included mortality, a transplant and recovery. Cox proportional hazard models were used to explore associated factors for mortality, cerebrovascular accident and pump thrombosis.
RESULTS: A total of 590 primary implants were included. The congenital group was significantly younger (2.5 vs 8.0 years, respectively, P < 0.001) and was more commonly supported by a pulsatile flow device (73.5% vs 59.9%, P < 0.001). Mortality was significantly higher in the congenital group (30.8% vs 20.4%, P = 0.009) than in the non-congenital group. However, in multivariable analyses, CHD was not significantly associated with mortality [hazard ratio (HR) 1.285; confidence interval (CI) 0.8111-2.036, P = 0.740]. Pump thrombosis was the most frequently reported adverse event (377 events in 132 patients; 0.925 events per patient-year) and was significantly associated with body surface area (HR 0.524, CI 0.333-0.823, P = 0.005), CHD (HR 1.641, CI 1.054-2.555, P = 0.028) and pulsatile flow support (HR 2.345, CI 1.406-3.910, P = 0.001) in multivariable analyses.
CONCLUSIONS: This fourth Paedi-EUROMACS report highlights the increasing use of paediatric VADs. The patient populations with congenital and non-congenital aetiologies exhibit distinct characteristics and clinical outcomes.