为接受腹腔大动脉动脉瘤修复的患者制定并发症指数
Renxi Li1, Anton Sidawy2, Bao-Ngoc Nguyen2
1George Washington University School of Medicine and Health Sciences, Washington, DC.
Journal of vascular surgery
|October 27, 2023
概括
腹腔大动脉动脉瘤 (AAA) 修复的新综合性并发症指数,包括内血管动脉瘤修复 (EVAR) 和开放式手术修复 (OSR),与一般的伊力豪瑟并发症指数 (ECI) 相比,显示出更好的住院死亡率歧视. 这些验证的指数标准化了AAA修复研究的并发症测量.
科学领域:
- 血管外科 血管外科
- 医疗保健服务研究 医疗服务研究
- 生物统计学 生物统计学
背景情况:
- 腹腔大动脉瘤 (AAA) 修复包括内血管动脉瘤修复 (EVAR) 和开放式手术修复 (OSR).
- 在临床研究中标准化并发症负担测量至关重要.
- 现有的通用并发症指数可能不准确地反映AAA修复中的患者风险.
研究的目的:
- 专门为接受EVAR和OSR的患者开发和验证综合并发症指数.
- 提高AAA修复研究中并发症评估的准确性.
- 为不同AAA修复研究中比较结果提供标准化指标.
主要方法:
- 从2015年底到2020年,接受EVAR或OSR的患者在国家住院患者样本 (NIS) 中被确定.
- 患者被随机分配到实验 (2/3) 和验证 (1/3) 组.
- 使用多变量后勤回归来确定 Elixhauser 同病重量,以开发 EVAR 和 OSR 特定指数.
主要成果:
- 开发的EVAR和OSR并发症指数表现出中等的区分能力和良好的校准.
- 这些新指数在区分住院死亡率方面显著超过了埃利克沙瑟并发症指数 (ECI).
- 内部和外部验证证实了新的综合性并发症指数的强表现,与个人并发症调整相美.
结论:
- 埃利克沙瑟并发症指数 (ECI) 在AAA修复患者中显示了低于最佳的性能.
- 开发的EVAR和OSR综合并发症指数得到了验证,在预测住院死亡率方面优于ECI.
- 这些指数提供了一个标准化的方法来衡量AAA修复研究中的并发症,提高了研究的可比性和复制性.
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