延迟与早期心脏转变在患有心房动症的患者中:基于人口的研究 (2015-2020)
Mohamed Salah Mohamed1, Anas Hashem1, Amani Khalouf1
1Department of Medicine, Rochester General Hospital, Rochester, NY 14621, USA.
Future cardiology
|August 31, 2023
概括
与早期心脏转变 (ECV) 相比,对心脏动症 (AF) 患者的延迟心脏转变 (DCV) 会增加急性心力衰竭 (AHF) 的风险和医疗费用. 在死亡率或其他主要结果方面没有观察到显著差异.
科学领域:
- 心脏病学 心脏病学
- 住院医疗 住院医疗 住院医疗
- 医疗保健服务研究 医疗服务研究
背景情况:
- 仅有有限的数据可以比较晚期心脏转变 (DCV) 和早期心脏转变 (ECV) 的临床结果,这些数据适用于心脏动症 (AF) 的患者.
- 了解这些差异对于优化患者管理和AF治疗中的资源配置至关重要.
研究的目的:
- 为了比较DCV与ECV的临床结果,在一大群 Paroxysmal AF患者中.
- 为了确定两种心脏转变策略之间的急性心力衰竭,停留时间,成本和死亡率的潜在差异.
主要方法:
- 通过使用2015年至2020年国家住院样本 (NIS) 数据库的数据进行了倾向性得分匹配分析.
- 这项研究包括17879名患有AF的患者,其中9725人接受了ECV和8154人接受了DCV.
- 针对主要临床结果计算了调整后的几率比率 (aOR).
主要成果:
- 与ECV相比,DCV与急性心力衰竭 (AHF) 的几率明显更高 (aOR 1.79; p < 0.01).
- 接受DCV的患者经历了更长的中位数停留时间 (4天与2天;p < 0.01) 和更高的住院费用 (33,410美元与21,738美元;p < 0.01).
- 在ECV和DCV组之间,没有发现住院患者死亡率或其他心血管和神经结果的显著差异.
结论:
- 在 Paroxysmal AF 患者中,延迟心转变与急性心力衰竭的增加率有关.
- 连续性疾病也与更大的资源利用有关,包括更长的住院时间和更高的成本.
- 这些发现表明,ECV可能是一个更有利的策略,从临床结果和医疗资源管理来看,对于精选的AF患者来说.
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