検体解剖における心臓移植電子機器の尋問:過小評価されている資源?
Philipp Lacour1, Claas Buschmann2, Christian Storm3
1Charité-Universitaetsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Cardiology (P.L., A.S.P., M.H., P.A., L.-H.B., B.P., W.H., F.B.).
Circulation
|June 20, 2018
まとめ
心臓 埋め込み 式 電子 装置 (CIED) の 死後 尋問 は,法医 が 死 の 原因 と 時間 を 決定 する の を 助ける. この分析は,CIEDの潜在的な安全問題も特定するのに役立ちます.
科学分野:
- 法医学病理学
- 心臓病科
- 医療機器の分析
背景:
- 心臓埋め込み電子機器 (CIED) の死後の尋問は,突然の心臓死亡の疑いがある場合に推奨されますが,めったに行われません.
- 法医病理学における組織的な死後のCIED分析データは欠けている.
研究 の 目的:
- 非選択的な死後のCIED尋問と法医病理学者のためのデータ分析の有用性を決定する.
- 死因,メカニズム,時刻の決定におけるCIED分析の役割を評価する.
- CIEDに関連する安全性の問題を特定する.
主な方法:
- 合計151件のCIEDが取り出され,5368件の解剖で5年間の期間 (2012年−2017年) にわたって150人の被験者に尋問された.
- その中にはペースメーカー,除細動器,インプラント可能なループレコーダーも含まれていた.
主要な成果:
- CIEDの尋問は,当初不確定であった症例の70%で死亡時刻と60.8%で死亡原因を決定するのに役立ちました.
- デバイスの問題は,ハードウェア,プログラミング,アルゴリズムの問題を含む,6.0%のケースで特定されました.
- 一つのCIEDは技術的な評価のために製造者分析を受けた.
結論:
- 死亡原因とタイミングを 正確に決定するために 法医学では 死後のCIEDの体系的な尋問が不可欠です
- CIED分析は,CIEDに関連する潜在的な安全問題を検出するための重要なツールとして機能します.
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