在患有外周动脉疾病的80岁及以上患者中,未充分利用指南建议的治疗方法
Daniel Messiha1, Olga Petrikhovich1, Julia Lortz1
1Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University of Duisburg-Essen, Germany.
VASA. Zeitschrift fur Gefasskrankheiten
|October 23, 2023
概括
患有外周动脉疾病 (PAD) 的老年人接受的指导方针建议的治疗和专业护理较少. 这凸显了与年龄相关的重大健康不平等在管理PAD,老龄化加剧的条件.
科学领域:
- 心血管医学 心血管医学
- 老年病的医生 老年病的医生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 衰老是一个重要的心血管风险因素,增加动脉样硬化负担和死亡率,特别是在外周动脉疾病 (PAD).
- 尽管有指南推的治疗方法,但它们在PAD护理中的实施往往是不充分的.
- 在高风险PAD人群中,与年龄相关的健康不平等在全国范围内仍未得到充分阐明.
研究的目的:
- 分析80岁以上的周围动脉疾病 (PAD) 患者的门诊治疗结构和准则遵守情况.
- 调查PAD患者患病率,药物治疗和专业门诊护理的年龄相关差异.
主要方法:
- 分析2009年至2018年德国全国范围的门诊索赔数据,每年覆盖7010万个人.
- 包括17,633,970名PAD患者,特别关注28%的80岁以上患者.
- 检查PAD患病率的年龄相关差异,他类药物和抗血小板药物治疗,以及获得专业护理 (血管学,血管外科,心脏病学) 的机会.
主要成果:
- 2008年至2018年间,PAD患病率从1.85%增加到3.14%,80岁以上患者的比例增加了三分之一.
- 与年轻患者相比,八代人群的治疗量不足于指导方针推的他类药物 (46.5%对52.4%),但接受抗血小板药物的频率更高 (30.6%对29.3%).
- 80岁及以上的患者获得专业门诊护理的机会较少,包括血管学 (6.4% vs 9.5%),血管外科手术 (8.1% vs 11.8%) 和心脏病学 (25.2% vs 29.2%).
结论:
- 在周围动脉疾病 (PAD) 患者的药物治疗和专业门诊护理中存在与年龄相关的显著差异.
- 总的来说,指南推的PAD门诊治疗是不理想的,80岁及以上的患者接受的基于证据的护理较少.
- 在PAD管理中解决这些与年龄相关的健康不平等问题是未来医疗保健的关键挑战.
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