紧急冠状动脉旁路移植的国家趋势
William B Keeling1, Jose Binongo2, Jane Wei2
1Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, GA, USA.
概括
紧急冠状动脉绕道移植 (CABG) 的数量在全国范围内下降. 虽然整体死亡风险下降,但紧急救援CABG显示死亡率增加,这表明目前的风险预测模型可能不足.
科学领域:
- 心血管外科心血管外科
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 紧急冠状动脉旁路移植 (CABG) 是一个关键的,但研究不足的程序.
- 了解紧急CABG的国家趋势对于评估医疗保健资源分配和患者结果至关重要.
研究的目的:
- 检查美国紧急和紧急救援冠状动脉旁路移植 (CABG) 程序的数量和结果的国家趋势.
主要方法:
- 胸腔外科医生协会全国成人心脏手术数据库 (2005-2017) 的分析.
- 包括92,607名接受紧急和紧急救援隔离CABG的患者.
- 利用通用线性混合模型来评估时间趋势,并考虑区域集群.
主要成果:
- 每年应急和紧急救援CABG数量从7991个案例下降到6916个案例.
- 总体预测死亡风险 (PROM) 从12%降至8%,术后发病率降低.
- 紧急救援CABG的观察到预期死亡率增加 (1.16至1.66),这些病例的平均死亡率为46.5%.
结论:
- 国家应急和应急救援CABG的数量有所下降.
- 在紧急救援CABG案件中增加的死亡率是一个重大问题.
- 当前的PROM算法可能无法准确评估紧急救援CABG患者的风险.
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