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亚裔美国人在透导管和外科动脉置换中存在差异

Renxi Li¹, Qianyun Luo², Marat Yanavitski³

¹The George Washington University School of Medicine and Health Sciences, Washington, DC, United States of America; Division of Cardiovascular and Thoracic Surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, United States of America.

Cardiovascular revascularization medicine : including molecular interventions

|September 6, 2023

概括

亚裔美国人在大动脉置换结果方面面临着显著的差异. 虽然通过导管的大动脉置换 (TAVR) 显示了类似的结果,但外科大动脉置换 (SAVR) 与这一群体的死亡率和并发症的增加有关.

科学领域:

心血管外科心血管外科
健康差异在健康上的差异
医疗保健服务研究医疗服务研究

背景情况:

确定的种族差异存在于大动脉置换 (AVR) 结果中,亚裔美国人的研究有限.
以前的研究主要集中在非洲裔美国人和西班牙裔美国人身上,造成了关于亚裔美国人的经验的知识差距.

研究的目的:

调查和确定亚裔美国人经历过过导管大动脉置换 (TAVR) 和手术大动脉置换 (SAVR) 的结果的差异.

主要方法:

利用2015-2020年国家住院样本 (NIS) 数据库来识别接受SAVR和TAVR的患者.
应用了1:2倾向性比分匹配来比较亚裔美国人和高加索患者.
分析了医院外科手术期间的结果,住院时间,从入院到手术的时间,以及医院总费用.

主要成果:

与高加索人相比,亚裔美国人在TAVR (1.31%) 和SAVR (1.93%) 均代表性不足.
没有观察到TAVR后并发症的显著差异,但亚裔美国人面临更长的等待时间和更高的成本.
在SAVR中,亚裔美国人经历了更高的住院死亡率,心脏性休克,呼吸道并发症,需要机械通风,急性损伤和出血/血瘤,以及更长的住院时间和成本增加.

结论:

亚裔美国人在AVR程序中代表性不足.
虽然TAVR的结果在亚裔美国人和白人之间是可比的,但SAVR与亚裔美国人的风险增加和结果较差有关.
鉴定的差异需要有针对性的干预措施,以促进亚裔美国人接受AVR的公平医疗保健结果.

关键词:

亚裔美国人亚裔美国人手术上更换大动脉门.通过导管更换大动脉门.

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