Læknablaðið - feb. 2020, Blaðsíða 17

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Heimildir
LÆKNAblaðið 2020/106 69
R A N N S Ó K N
búa til viðmiðunarhóp sem væri sambærilegur með tilliti til bak-
grunns sjúklinganna fyrir aðgerð. Pörunin reyndist ekki möguleg
vegna smæðar gagnagrunnsins.
Styrkleikar rannsóknarinnar eru að gagnagrunnurinn geymir
ítarlegar upplýsingar um hvern og einn sjúkling en hann tekur
til allra sjúklinga sem gengust undir kransæðahjáveituaðgerð
hjá heilli þjóð á 18 ára tímabili. Auk þess voru aðgerðirnar fram-
kvæmdar á einni stofnun af tiltölulega fáum læknum, sem tryggir
einsleitari sjúklingahóp og samræmi á milli aðgerða. Loks er
styrkleiki að eftirfylgd var 100% og brottfall sjúklinga með tilliti
til lifunar því hverfandi.
Rannsóknin sýnir að innan við 5% sjúklinga fá ósæðardælu
í tengslum við kransæðahjáveitu á Íslandi. Algengasti áhættu-
þáttur fyrir notkun dælunnar var alvarleg hjartabilun þar sem
útstreymisbrot vinstri slegils var verulega skert, eða undir 30%
(eðlilegt 50-60%). Tíðni fylgikvilla og 30 daga dánartíðni voru eins
og búast mátti við hærri hjá sjúklingum sem fengu ósæðardælu,
og langtíma- og MACCE-frí lifun þeirra umtalsvert síðri, sem
skýrist helst af því að þessir sjúklingar voru mun veikari fyrir að-
gerðina frekar en að það megi reka til notkunar ósæðardælunnar.
Þessi rannsókn svarar því ekki hvort ósæðardæla sé gagnleg eða
skaðleg hjá þessum sjúklingum, enda ekki framskyggn. Frekari
rannsóknir með stærri sjúklingaefnivið þarf til þess, og þar væri
framskyggn rannsókn æskileg.
Þakkir
Þakkir fá læknar á hjarta- og lungnaskurðdeild Landspítala og á
gjörgæsludeild. Rannsóknin var styrkt af Vísindasjóði Landspít-
ala, Rannsóknarsjóði Háskóla Íslands og Minningarsjóði Helgu
Jónsdóttur og Sigurliða Kristjánssonar.
Greinin barst til blaðsins 18. október, samþykkt til birtingar 3. janúar 2020.