少数群体使用左心室辅助装置:对全国住院患者样本的分析
Mustafa M Ahmed1, Lauren E Meece1, Yi Guo2
1From the Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida.
ASAIO journal (American Society for Artificial Internal Organs : 1992)
|October 3, 2023
概括
当考虑社会经济因素时,使用左心室辅助器件 (LVAD) 治疗心脏性休克时的种族差异并不明显. 需要进一步的研究来了解这种至关重要的心力衰竭治疗的不足.
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
- 医学经济学 医学经济学
背景情况:
- 左心室辅助装置 (LVAD) 植入是晚期心力衰竭的关键治疗方法.
- 现有的数据表明,少数群体接受LVAD的频率较低,但这可能无法解释特定的临床情景.
- 了解LVAD在心脏性休克中的利用对于解决潜在差异至关重要.
研究的目的:
- 调查心力衰竭和心脏发生性休克住院患者中的LVAD利用率.
- 在这个特定的患者群体中检查LVAD植入的潜在种族差异.
- 确定影响LVAD访问和结果的因素.
主要方法:
- 国家住院患者样本 (2013-2019) 的分析,包括患有初级心力衰竭和心脏性休克的患者.
- 定义LVAD的使用为在心脏性休克住院期间接受该设备.
- 利用多变量建模来评估种族,纳税人地位,收入和伴随疾病对LVAD接收和结果的影响.
主要成果:
- 在所有种族群体中,LVAD的整体使用率都很低.
- 非西班牙裔黑人经历了更长的住院时间,更高的出院率和更低的住院死亡率.
- 在控制了社会经济因素和并发症后,种族不是使用LVAD的重要预测因素.
结论:
- 左心室辅助器件在心脏性休克患者中未得到充分利用.
- 对于心脏病性休克使用LVAD的种族差异似乎是由社会经济因素和并发症解释的,而不是种族本身.
- 需要进一步努力,以增加LVAD的访问和解决这一救命疗法的障碍.
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