医学
倾向得分匹配
单中心
内科学
对数秩检验
肺移植
回顾性队列研究
外科
生存分析
移植
作者
Mohammed A. Kashem,Hannah Calvelli,Michael Warnick,Hiromu Kehara,Vipin Dulam,Huaqing Zhao,Roh Yanigada,Norihisa Shigemura,Yoshiya Toyoda
标识
DOI:10.1093/ejcts/ezae150
摘要
Abstract OBJECTIVES As life expectancies continue to increase, a greater proportion of older patients will require lung transplants (LTs). However, there are no well-defined age cutoffs for which LT can be performed safely. At our high-volume LT centre, we explored outcomes for LT recipients ≥70 vs <70 years old. METHODS This is a retrospective single-centre study of survival after LT among older recipients. Data were stratified by recipient age (≥70 vs <70 years old) and procedure type (single versus double LT). Demographics and clinical variables were compared using Chi-square test and 2 sample t-test. Survival was assessed by Kaplan–Meier curves and compared by log-rank test with propensity score matching. RESULTS A total of 988 LTs were performed at our centre over 10 years, including 289 LTs in patients ≥70 years old and 699 LTs in patients <70 years old. The recipient groups differed significantly by race (P < 0.0001), sex (P = 0.003) and disease aetiology (P < 0.0001). Older patients were less likely to receive a double LT compared to younger patients (P < 0.0001) and had lower rates of intraoperative cardiopulmonary bypass (P = 0.019) and shorter length of stay (P = 0.001). Both groups had overall high 1-year survival (85.8% vs 89.1%, respectively). Survival did not differ between groups after propensity matching (P = 0.15). CONCLUSIONS Our data showed high survival for older and younger LT recipients. There were no statistically significant differences observed in survival between the groups after propensity matching, however, a trend in favour of younger patients was observed.
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