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  2. 介入性心脏病学医生认证与穿皮冠状动脉干预的住院结果的关联
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  2. 介入性心脏病学医生认证与穿皮冠状动脉干预的住院结果的关联

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介入性心脏病学医生认证与穿皮冠状动脉干预的住院结果的关联

Paul N Fiorilli1, Karl E Minges1, Jeph Herrin1

  • 1From Section of Cardiovascular Medicine, Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia (P.N.F.); Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (K.E.M., J.J.B., J.P.C.); Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (J.H., J.P.C.); Health Research & Educational Trust, Chicago, IL (J.H.); Department of Medicine, Division of Cardiology, University of Colorado, Denver, Aurora (J.C.M.); University Hospital of Columbia and Cornell, New York-Presbyterian Hospital, New York (H.H.T.); University of Michigan, Department of Internal Medicine, Division of Cardiovascular Medicine, Ann Arbor (B.K.N.); American Board of Internal Medicine, Philadelphia, PA (R.S.L., B.J.H.); Hess Consulting, St. Nicolas, QC, Canada (B.J.H.); and Accreditation Council for Graduate Medical Education, Chicago, IL (E.S.H.).

Circulation
|September 20, 2015

在PubMed 上查看摘要

概括
此摘要是机器生成的。

干预性心脏病学认证并不总是预测穿皮冠状动脉干预 (PCI) 后的患者结果. 虽然未经认证的医生有更高的死亡率和绕道手术风险,但其他并发症类似,质疑认证

关键词:
急性冠状动脉综合征急性心肌梗塞血管整形术基于导管的冠状动脉干预,支架慢性缺血性心脏病冠状动脉复血管化卫生政策和结果研究登记册

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科学领域:

  • 心脏病学
  • 医疗服务研究

背景情况:

  • 美国内科医学会 (ABIM) 的分专业认证的价值正在受到审查.
  • 评估干预心脏病学 (ICARD) 认证对患者结果的影响至关重要.

研究的目的:

  • 评估ICARD认证与接受皮肤冠状动脉干预 (PCI) 患者的住院结果之间的关联.
  • 确定ICARD认证是否是程序成功和患者安全的可靠指标.

主要方法:

  • 在2010年对来自CathPCI注册表的510,708个PCI程序进行分析.
  • 在ICARD认证和非认证医生之间的住院结果的比较.
  • 根据患者特征和PCI体积调整的等级多变量模型.

主要成果:

  • 在经过认证和未经认证的医生组之间没有明显的差异或未经调整的结果.
  • 在非ICARD认证医生治疗的患者中,住院死亡率 (OR 1. 10) 和紧急冠状动脉旁路移植 (OR 1.32) 的风险更高.
  • 没有出血,血管并发症或复合不良结果的统计显著差异.

结论:

  • 仅仅是ICARD认证并不是PCI患者结果的强有力的预测指标.
  • 这些发现表明需要提高介入心脏病学子专业认证的价值和预测能力.
  • 虽然非认证医生的死亡率和紧急绕道风险较高,但其他并发症的发生率相似.