韩国腹腔大动脉动脉瘤的治疗:一项全国性的研究
Hyangkyoung Kim1, Tae-Won Kwon2,3,4, Yong-Pil Cho2
1Department of Surgery, Ewha Womans University College of Medicine, Seoul, Korea.
Annals of surgical treatment and research
|July 13, 2023
概括
在韩国,开放式手术修复 (OSR) 可能为腹腔大动脉动脉瘤 (AAA) 治疗提供更好的长期结果和成本效益,而不是内血管动脉瘤修复 (EVAR),尽管EVAR.
科学领域:
- 血管外科 血管外科
- 卫生经济学 卫生经济学
- 公共卫生 公共卫生
背景情况:
- 内血管动脉瘤修复 (EVAR) 越来越多地用于腹腔大动脉瘤 (AAA) 治疗.
- 在韩国人群中对EVAR与开放性手术修复 (OSR) 的比较研究有限.
- 了解长期结果和成本效益对于临床决策至关重要.
研究的目的:
- 为了比较韩国人口中AAA治疗的EVAR和OSR的长期结果和成本.
- 评估EVAR和OSR之间的术后,早期和长期生存率.
- 评估两种治疗方式的再干预率,并发症和相关成本.
主要方法:
- 对韩国国家医疗保险服务数据库 (2008-2019) 的回顾性分析.
- 对AAA进行EVAR或OSR的患者的鉴定.
- 术后和长期结果的比较,包括存活,重新干预,并发症和成本,随访到2020年.
主要成果:
- EVAR显示了较低的术后死亡率 (4.2%与8.0%,P<0.001),即使在没有破裂的病例 (2.7%与3.3%,P=0.003).
- 每100人年的长期死亡率高于EVAR (9.0对6.4,P<0.001),OSR显示所有原因死亡率较低 (HR,0.9;95%CI,0.87-0.97;P=0.008).
- EVAR与AAA相关的再干预率 (1.75对每100人/年0.52) 和成本 (6,153,463美元对624,216美元) 显着更高.
结论:
- 在韩国,Evar为AAA治疗提供了短期生存益处.
- 在韩国医疗保健系统中,OSR可以提供优越的长期结果和成本效益.
- 进一步的研究可能会探索患者选择标准,以优化AAA治疗策略.
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