心脏导管,冠状动脉干预和跨导管大动脉置换的等待时间
Sudershan Srinivasan1, Alexandra Novelli1, Peter Callas2
1Department of Medicine, University of Vermont Larner College of Medicine.
Coronary artery disease
|October 6, 2023
概括
大约50%的患者实现了通过导管的大动脉置换 (TAVR) 的短等待时间. 更生病的患者和那些不需要TAVR前手术的患者更有可能有更短的等待时间.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 过导管大动脉置换 (TAVR) 的延长等待时间与患者发病率和死亡率的增加有关.
- 了解影响短 TAVR 等待时间 (STWT) 的因素对于改善患者的治疗结果至关重要.
研究的目的:
- 定义TAVR短等待时间 (STWT) 的发生率和预测因素,定义为从转诊到手术后≤30天.
- 检查临床特征,人口统计和TAVR前心脏导管治疗对TAVR等待时间的影响.
主要方法:
- 从2019年到2022年中期接受TAVR的831名患者的回顾性观察分析.
- 分析包括人口统计数据,相对于COVID-19发病的时间,TAVR中心的旅行距离,基线临床因素和过程变量.
- 进行了单变量和多变量分析,以确定STWT的预测因素.
主要成果:
- 大约50%的患者实现了STWT.
- 在COVID-19大流行期间,STWT的比例更高 (54.7%vs45.2%).
- 患有较高左心室喷射率 (>60%) 的患者和需要TAVR前导管或PCI的患者的等待时间较长.
结论:
- TAVR等待时间没有受到COVID-19大流行或旅行距离的显著影响.
- 患有更严重临床条件的患者更有可能经历STWT.
- 在TAVR之前的心脏导管或PCI等手术与更长的等待时间有关.
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