リコールされたペースメーカーとインプラント可能な心臓転換器-除細動器の管理:意思決定分析モデル
Mitesh S Amin1, David B Matchar, Mark A Wood
1Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, USA.
JAMA
|July 27, 2006
まとめ
アドバイザリーの下で埋め込み器具を交換するかどうかを決定することは,故障率と死亡リスクに左右されます. 器具の交換は,ペースメーカーの場合の故障率が0.3%,除細動器の場合の故障率が1.0~3.0%を超えると好ましいことが多い.
科学分野:
- 心臓病学 心臓病学
- バイオメディカルエンジニアリング
- 健康に関する意思決定分析 分析
背景:
- アドバイザリの下の埋め込み器具の臨床管理ガイドラインは限られている.
- 継続的なモニタリングとデバイス交換のリスクと利点を理解することは,臨床医にとって非常に重要です.
研究 の 目的:
- 意思決定分析を使用して,アドバイザリの下で,植入可能なデバイスの最適な管理戦略を決定します.
- 即時のデバイス交換と継続的な臨床フォローアップを比較する.
主な方法:
- 決定モデルが開発され,監視と対比して即時代替のリスクと利益を評価しました.
- 重要な変数には,デバイスの故障率 (年間0.01%1.0%) と置換死亡率 (0.10%1.00%) が含まれていた.
主要な成果:
- デバイス交換の決定は,主に故障率と死亡率の影響によって引き起こされます.
- ペースメーカーに依存する患者は,失敗率が0.3%を超える場合,交換を正当化することがあります.
- 埋め込み心房変容器-除細動器置換の決定は,失敗率 (1.0%3.0%),処置による死亡率,および不律症のリスクに基づいて異なります.
結論:
- リコールされたデバイスを交換する決定は,故障発生率と故障の影響に依存します.
- この分析は,デバイス,患者,および制度的要因を考慮して,リコールされたデバイスを管理するための枠組みを提供します.
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