最少入侵的方法与大动脉和心心膜手术后的资源利用率较低有关
NaYoung K Yang1, Fady K Soliman1, Russell J Pepe1,2
1Division of Cardiothoracic Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.
JTCVS open
|October 9, 2023
概括
微创心脏手术 (MICS) 与全胸骨切割 (FS) 相比,大大降低了左心操作的资源利用率和成本. 此外,MICS还导致住院时间缩短,并发症减少,从而改善患者的治疗结果.
科学领域:
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
- 卫生经济学 卫生经济学
背景情况:
- 最少侵入性心脏手术 (MICS) 与传统的全胸骨切除术 (FS) 相比,在左心手术中具有潜在的好处.
- 评估资源利用,成本效益和术后结果对于选择外科手术方法至关重要.
研究的目的:
- 为了比较MICS与FS对资源利用,直接成本和单次左心手术的患者的术后结果的影响.
- 确定影响门外科手术高资源利用率的因素.
主要方法:
- 从2018-2021年对接受大动脉或心心门手术的患者的单一中心数据的回顾性审查.
- 通过手术方法对患者进行分层:MICS与全胸骨切除 (FS) 相比.
- 分析主要结果 (高资源利用率) 和二次结果,包括成本,停留时间,再接收,死亡率和发病率,对关键变量进行多变量回归控制.
主要成果:
- 与FS相比,MICS与高资源利用率 (31.25%对61.29%,P <.001) 的显著降低有关.
- 接受MICS治疗的患者的中位术后停留时间较短 (4天与6天,P < .001),直接成本较低 (22,900美元与31,900美元,P < .001).
- FS与术后心房和功能衰竭的增加率有关;多变量分析证实FS增加了高资源利用率的可能性 (P < .001).
结论:
- 最少侵入性心脏手术 (MICS) 证明了左心操作的卓越资源利用和成本效益.
- MICS与术后结果的改善有关,包括停留时间缩短和并发症减少.
- 这些发现支持MICS作为选择左心病态的首选方法,优化患者护理和资源管理.
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