肺高血压与它对30天死亡率,再入院和跨导管大动脉置换后的成本的影响之间的关联:一个多中心研究
Mansoor Ahmad1, Juan Del Cid Fratti1, Mena Henien1
1Cardiology, University of Illinois College at Chicago Peoria, Peoria, USA.
Cureus
|June 30, 2023
概括
严重的肺高血压 (PH) 显著增加了30天的死亡率和ICU停留在接受过导管大动脉置换 (TAVR) 的患者. 然而,PH的严重程度并没有影响再接收率或总体成本.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 干预心脏病学 干预心脏病学
背景情况:
- 肺高血压 (PH) 是严重的大动脉狭窄的常见并发症.
- 超导管大动脉置换 (TAVR) 是对大动脉狭窄的既定治疗方法,但它对PH及其相关结果的影响需要进一步研究.
研究的目的:
- 评估不同程度的肺高血压对接受TAVR的患者临床结果和医疗保健成本的影响.
- 评估术前肺压力与30天死亡率,再入院,ICU停留时间和入院费用之间的关系.
主要方法:
- 在2012年12月至2020年11月期间,对474名接受TAVR的患者进行了多中心的回顾性分析.
- 患者根据右心室缩压 (RVSP) 分为四组:正常 (<35mmHg),轻度 (35-45mmHg),中度 (46-60mmHg) 和严重 (>60mmHg).
- 分析的结果包括30天死亡率,30天再入院,ICU停留时间和入院费用,使用千平方,T测试和多变量回归进行统计分析.
主要成果:
- 与正常或轻度PH患者相比,患有严重PH的患者的30天死亡率明显更高 (OR:6.77,p=0.04).
- 严重的PH与显著更长的ICU停留时间有关 (平均:18.2小时,p<0.001).
- 在不同PH严重程度组的30天再入院率 (p=0.859) 或入院费用 (p=0.810) 中没有发现显著差异.
结论:
- 严重的肺高血压是TAVR后30天死亡率增加和长时间ICU停留的独立风险因素.
- 术前肺高血压的严重程度似乎没有影响30天的再入院率或TAVR后的整体入院成本.
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