高齢の患者の間で選択的皮経冠動脈介入後の当日出院の発生率と結果
Sunil V Rao1, Lisa A Kaltenbach, William S Weintraub
1Duke Clinical Research Institute, 508 Fulton St, Durham, North Carolina, USA. sunil.rao@duke.edu
JAMA
|October 6, 2011
まとめ
選択性皮経冠動脈介入 (PCI) の翌日の排泄は,高齢の患者ではまれですが,30日以内に死亡または再入院のリスクを増加させることはありません. このアプローチは,選択された低リスクの個人に安全です.
科学分野:
- 心臓病学 心臓病学
- 医療サービス 研究 医療サービス
背景:
- 選択的な皮膚経冠動脈介入 (PCI) は,通常,高齢者の患者にとって,一晩間の入院観察を伴う.
- 同日退院の安全性は,この集団にとって依然として不明である.
研究 の 目的:
- 米国で選択PCIを受ける高齢患者の同日出院の流行と結果を決定する.
- 同日退院と死亡や再入院などの有害事象との関連性を評価する.
主な方法:
- 多センターコホート研究では,選択PCIを受けている65歳以上の107,018人の患者のデータを分析した.
- データ源はCathPCIレジストリ (2004-2008) であり,Medicareのクレームとリンクされています.
- 患者は,当日退院または一晩滞在のグループに分類されました.
主要な成果:
- 同日の排出は珍しい (1.25%) で,施設レベルでの大きな変動がありました.
- 2日または30日間の死亡率または再入院率は,グループ間で有意な差異は見られなかった.
- 調整した分析では,同日退院は30日間の不良結果と有意に関連していないことが示された.
結論:
- 選択性PCIを受ける高齢で低リスクの患者では,同日出院はまれに使用されます.
- この方法は安全で,夜間観察と比較して死亡または再入院のリスクが増加していない.
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