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医院种族组成和大动脉置换结果之间的关联:全国住院患者样本数据库分析

Yanfei Chen¹, Yue Xiao¹, Ruijian Huang¹

¹School of International Business, China Pharmaceutical University, Nanjing, China.

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

|February 14, 2024

概括

更高的医院种族多样性与大动脉置换患者的情况更差,包括并发症和成本增加. 然而,通过导管的大动脉植入术的结果在所有多样性水平上都得到了改善.

科学领域:

心血管外科心血管外科
医疗保健服务研究医疗服务研究
健康公平卫生公平

背景情况:

种族和民族差异被记录在外科动脉置换 (SAVR) 和透气管动脉植入 (TAVI) 的结果中.
医院种族构成在这些差异中的作用仍然不清楚.

研究的目的:

调查医院的种族组成和SAVR和TAVI后患者的结果之间的关联.
确定医院的种族多样性是否会影响教科书的结果,并发症,住院时间和费用.

主要方法:

分析国家住院样本 (NIS) 数据库 (2015-2019) 对接受SAVR或TAVI的大动脉狭窄患者的分析.
使用种族/民族多样性指数 (RDI) 评估医院的种族组成.
统计建模以评估RDI五分位数和术后结果之间的关系,包括教科书结果,急性损伤 (AKI),输血,成本和停留时间 (LOS).

主要成果:

较高的RDI五分位数与SAVR和TAVI实现教科书结果的几率明显降低.
随着较高的RDI,观察到AKI和输血率的增加.
有较高RDI的医院也显示成本增加和较长的LOS.
在TAVI后的结果显示,从2015年到2019年,所有RDI五分位数都出现了改善.

结论:

医院的种族组成与SAVR和TAVI结果的差异有关,更高的多样性与较差的结果有关.
更高的RDI医院面临的挑战包括教科书结果率较低,并发症增加和医疗保健成本更高.
虽然TAVI结果在所有RDI组都得到改善,但需要进一步的研究来解决SAVR的差异.

关键词:

大动脉狭窄症是什么医院的种族组成.手术上更换大动脉门.穿过导管的大动脉植入装置.

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