经过十年的心脏再同步治疗后,预后得到改善.
Francisco Leyva1, Abbasin Zegard1,2, Peysh Patel2
1Aston Medical Reseach Insitute, Aston Medical School, Aston University, Aston Triangle, Birmingham B4 7ET, UK.
概括
在过去的十年里,心脏再同步治疗 (CRT) 改善了存活率,并减少了英格兰心力衰竭住院的病例. 对于CRT患者来说,这些积极的结果发生了,尽管患者的并发症增加了.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 医疗器械技术 医疗器械技术
背景情况:
- 在过去的十年中,心力衰竭 (HF) 患者的心脏再同步治疗 (CRT) 已经显著增加.
- 了解CRT对公共卫生系统中临床结果的影响,对于资源配置和患者护理至关重要.
研究的目的:
- 从2010年到2019年,评估CRT植入后临床结果的变化.
- 评估患者伴随性疾病负担增加对国家医疗保健系统中CRT有效性的影响.
主要方法:
- 在2010年至2019年期间,对64698名在英国接受CRT植入 (CRT除或CRT节奏) 的患者的国家数据库的分析.
- 检查CRT植入率,患者人口统计,并发病 (高血压,糖尿病,慢性病) 和查尔森并发病指数 (CCI) 的趋势.
- 统计分析30天,1年,2年死亡率,死亡率或HF住院,并对多种临床因素进行调整.
主要成果:
- 从2010-2011年到2018-2019年,CRT植入的数量增加了76%.
- 在接受CRT的患者中,关键并发症 (高血压,糖尿病,慢性病) 和较高的CCI (≥3) 的患病率显著增加.
- 尽管并发症负担上升,但在30天死亡率 (1.43%至1.09%),1年死亡率 (9.51%至8.13%) 和2年死亡率或HF住院 (HR:0.59) 中观察到显著下降.
结论:
- 在过去的十年里,在英国公共卫生系统中,CRT植入导致了更好的生存率和心力衰竭住院减少.
- 尽管患者的并发症复杂性显著增加,但CRT的预后益处一直保持不变.
- 这些发现强调了CRT在管理大规模医疗保健环境中的心力衰竭患者的持续价值.
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