患者的风险-好处偏好用于透导管与外科手术中枢门修复
Anna Hung1,2,3, Jui-Chen Yang1, Matthew Wallace1
1Duke Clinical Research Institute, Duke University School of Medicine Durham NC USA.
Journal of the American Heart Association
|March 12, 2024
概括
患有 mitra 反的患者通常更喜欢通过导管边缘到边缘修复 (TEER) 而不是手术,接受更高的风险,以减少侵入性手术. 需要显著的功能改善才能优先进行手术.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 患者报告的结果
背景情况:
- 过导管边缘到边缘修复 (TEER) 对于额头回是不那么侵入性比手术.
- 然而,TEER与更高的5年死亡率和重新干预风险有关.
- 与手术相比,TEER在身体功能方面也产生了较小的改善.
研究的目的:
- 量化患者对TEER和手术中枢门修复之间的风险和益处权衡的偏好.
- 了解患者愿意接受某些风险,以获得不那么侵袭的治疗方案.
主要方法:
- 进行了一项离散选择实验调查,对201名患有 mitra regurgitation 的患者进行了调查.
- 调查属性包括手术类型,死亡风险 (30天和5年),身体功能,住院和重新干预风险.
- 一个混合逻辑回归模型分析了偏好权重.
主要成果:
- 患者主要喜欢TEER而不是手术.
- 为了选择TEER,患者接受了更高的风险:再干预风险高达13.3%,额外住院4.6次,五年死亡风险高达10.7%.
- 患者还接受了近一个纽约心脏协会的课程,在5年内降低了身体功能.
结论:
- 患者通常倾向于对腹吐进行不那么侵入性的TEER手术.
- 平均而言,在5年内,身体功能 (NYHA III至I级) 显著改善是必要的,以便患者优先选择手术而不是TEER.
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