直接入院与医院间转移用于非ST段升高心肌梗塞的重血管化
Gijs J van Steenbergen1, Jesse P A Demandt1, Daniela N Schulz1
1Catharina Heart Centre, Catharina Hospital, Eindhoven, The Netherlands.
Clinical cardiology
|June 22, 2023
概括
将非ST段升高心肌梗塞 (NSTEMI) 患者直接接收到干预中心可以减少住院时间和成本. 与一般中心入院相比,临床结果仍然相似.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 对于NSTEMI患者的结果和过程参数因初次入院中心而异.
- 对干预中心与NSTEMI护理一般中心的直接入院情况尚不清楚.
研究的目的:
- 为了比较NSTEMI患者的过程指标,成本和临床结果,基于他们最初的呈现中心 (干预与一般).
- 分析这些招生群体内复血管化策略 (PCI,CABG,noRevasc) 的影响.
主要方法:
- 使用了2017-2019年NSTEMI患者的医院索赔数据.
- 根据初次入院中心和再血管化策略分层患者.
- 主要结局:住院时间长度. 二次结果:程序的时间,冠状动脉内程序,30天的MACE和总成本.
主要成果:
- 直接入院到干预中心与更短的住院时间 (五天而不是七天) 相关联.
- 在干预中心的PCI和CABG患者经历了更快的再血管化时间和更少的手术.
- 对于直接干预中心的入院,总费用明显较低 (10,211欧元对13,741欧元).
- 主要不良心脏事件 (MACE) 在两组之间是可比的 (11.8%与12.4%).
结论:
- 将NSTEMI患者直接提交给干预中心,可以提高效率.
- 较短的住院时间,缩短的再血管化时间,较少的手术和较低的成本与直接干预中心的入院相关.
- 直接干预中心的入院不会对临床结果 (MACE) 产生负面影响.
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