オランダ の 病院 で の トランスキャテーター の 大動脈弁 置換 術 の 次日 の 退院
Diekje R Schouten1, Josianne H Heuver2, Wendy Stouten-Gresnigt2
1Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands. d.schouten@antoniusziekenhuis.nl.
まとめ
トランスキャテーターによる大動脈弁置換 (TAVR) の翌日の放出 (NDD) は,オランダでは安全で実行可能である. TAVR患者の半数以上が退院後の合併症を最小限に抑えて NDD を達成し,その普及を後押しした.
科学分野:
- 心臓病科
- 介入心臓科
- 医療管理
背景:
- トランスカテーターによる大動脈弁置換 (TAVR) の後の入院期間は減少しています.
- 以前の研究では,翌日の放出 (NDD) が安全であることが示されています.
- オランダの医療環境におけるNDDの実現可能性に関するデータは限られている.
研究 の 目的:
- TAVR患者の翌日の退院政策の実効性を評価する.
- TAVR後のNDDに関連する患者の安全性と合併症率を評価する.
- NDD戦略を実行しているオランダの病院のデータを提供します.
主な方法:
- 2022年に翌日の解約 (NDD) 政策が実施されました.
- 2022 年 8 月から 2024 年 8 月までの選択的な TAVR 患者は含まれていました.
- 排除基準: 既存の入院, トランスアピカルアクセス, 処置中の死亡率
主要な成果:
- 460人のTAVR患者の58. 5%でNDDを達成した (平均年齢80. 1歳).
- 退院後30日間の合併症率は低い: 永久的なペースメーカーインプラントの1. 9%,軽度の血管合併症の2. 2%.
- 死亡率,主要な血管合併症,または入院中風は観察されなかった.
結論:
- TAVRの翌日の解約政策を 実施することは可能である.
- TAVR患者の大部分は翌日に無事に退院できます.
- NDDは退院後の合併症の発生率が低い.
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