跨导管大动脉置换等待时间的时间趋势和临床后果:基于人口的研究
Gabby Elbaz-Greener1, Shannon Masih2, Jiming Fang2
1Schulich Heart Centre, Division of Cardiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada (G.E-G., D.T.K., H.C.W.).
Circulation
|March 8, 2018
概括
通过导管的动脉置换 (TAVR) 等待时间在补偿后稳定,但仍然很长. 这些延迟与患者的死亡率和发病率有关,强调需要增加TAVR的容量和获取能力.
科学领域:
- 心脏病学
- 干预心脏病学
- 医疗服务研究
背景情况:
- 超导管大动脉置换 (TAVR) 是严重的大动脉狭窄症的关键治疗方法.
- 对TAVR的需求增加可能会超过医疗保健能力,导致等待时间更长,患者的访问减少.
- 评估TAVR等待时间趋势及其临床影响对于优化患者护理至关重要.
研究的目的:
- 分析TAVR等待时间的时间趋势.
- 评估与TAVR等待时间相关的临床后果,包括死亡率和住院情况.
- 确定省级退款是否影响了TAVR等待时间和结果.
主要方法:
- 在加拿大安大略省的一项基于人口的研究中,从2010年4月到2016年3月确定了TAVR转诊情况.
- 从转诊到TAVR程序的中位数总等待时间是主要结果.
- 分段回归分析了2012年9月退款前后的趋势;临床结果包括等待名单死亡率和心力衰竭住院情况.
主要成果:
- 这项研究包括4461名转诊者,其中50%接受了TAVR.
- 平均等待时间稳定在退款后的80天,没有变化.
- 等待名单死亡率约为2%,心力衰竭住院率为12%,随着等待时间的延长,病例增加.
结论:
- 自退款以来,TAVR的等待时间保持稳定,约为80天,这表明产能与需求相匹配.
- 尽管等待时间稳定,但近3个月的延迟与严重的发病率和死亡率有关.
- 增加TAVR容量和改善接入是必要的,以减轻等待手术的患者的不良临床结果.
更多相关视频
相关概念视频
Timing and Consequences on Behavior
437
In operant conditioning, the timing of reinforcement is crucial. For animals like rats and cats, immediate reinforcement (within a few seconds) is much more effective than delayed reinforcement. For example, a food reward for a rat needs to follow within 30 seconds of pressing a bar to be effective.
Humans, however, can respond to delayed reinforcers. We often make decisions between immediate small rewards and delayed larger rewards. This ability to delay gratification is a significant...
Humans, however, can respond to delayed reinforcers. We often make decisions between immediate small rewards and delayed larger rewards. This ability to delay gratification is a significant...
437
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
575
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
575
What is Population Genetics?
65.0K
A population is composed of members of the same species that simultaneously live and interact in the same area. When individuals in a population breed, they pass down their genes to their offspring. Many of these genes are polymorphic, meaning that they occur in multiple variants. Such variations of a gene are referred to as alleles. The collective set of all the alleles within a population is known as the gene pool.
65.0K
Population Growth
28.7K
Population size is dynamic, increasing with birth rates and immigration, and decreasing with death rates and emigration. In ideal conditions with unlimited resources, populations can increase exponentially, which plots as a J-shaped growth rate curve of population size against time. This type of curve is characteristic of newly-introduced invasive species, or populations that have suffered catastrophic declines and are rebounding.
28.7K
Conservation of Small Populations
17.4K
Small population sizes put a species at extreme risk of extinction due to a lack of variation, and a consequent decrease in adaptability. This weakens the chances of survival under pressures such as climate change, competition from other species, or new diseases. Large populations are more likely to survive pressures such as these, as such populations are more likely to harbor individuals that have genetic variants that are adaptive under new stresses. Small populations are much less...
17.4K
Current Trends in Nursing I
5.5K
Current trends in nursing include:
5.5K


