在农村人口中,皮肤穿透冠状动脉干预后当天出院的结果
Wilson L Ginete1, Nicole A Groth2, Macaela N Rudeck2
1Essentia Health Heart and Vascular Center, Duluth, Minnesota, USA.
概括
穿皮冠状动脉干预 (PCI) 后的当日出院对农村患者来说是安全的,没有增加再入院率. 这些患者的死亡率也较低,这表明SDD是一个可行的选择.
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:
- 穿皮冠状动脉干预 (PCI) 后的当天排出 (SDD) 是安全的,但在全国范围内未得到充分利用.
- 对于农村地区的患者,SDD的安全性在很大程度上仍未得到审查.
研究的目的:
- 对居住在农村地区的PCI患者来说,评估SDD与第二天出院 (NDD) 的安全性.
主要方法:
- 在第三级护理中心对2099例门诊选择性PCI (2011-2017年) 的回顾性分析.
- 使用国家心血管数据注册表和电子医疗记录;使用农村-城市通勤区代码定义农村状态.
- 将SDD和NDD组之间的结果进行比较,分析30天再入院和1年和5年死亡率.
主要成果:
- 15.7%的符合条件的患者 (52.3%的农村地区) 进行了SDD;随着辐射接入的采用,SDD的发生率增加了.
- 在30天的再入院中,SDD不低于NDD.
- 与NDD相比,SDD患者的全因死亡率在1年 (aOR 0.20) 和5年 (aOR 0.43) 中显著降低.
结论:
- 同日出院是农村地区PCI患者的安全策略,30天再入院的病例没有增加.
- 与第二天出院相比,SDD与长期死亡率的降低有关.
- 建议进行进一步的前性研究,以确认SDD在这个人群中的安全性.
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