带有和没有心肌狭窄的跨导管大动脉植入 - 一个国家再接收数据库研究
Shafaqat Ali1, Harshith Thyagaturu2, Lalitsiri Atti3
1Department of Internal Medicine, Louisiana State University, Shreveport, LA, USA.
概括
经过过导管大动脉植入术 (TAVI) 并且同时患有中枢狭窄症 (MS) 的患者面临更高的30天再入院率和增加的住院费用. 这些发现凸显了与同时患有多发性硬化症的TAVI患者相关的重大医疗负担.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 额头管狭窄症 (MS) 经常与需要跨导管大动脉植入 (TAVI) 的情况共存.
- 高达20%的TAVI患者可能有并发性多发性硬化症,这引发了人们对手术风险和结果的担忧.
- 多发性硬化和TAVI之间的相互作用需要更仔细地检查相关的心脏不良事件.
研究的目的:
- 调查并发性心关节狭窄症 (MS) 对经过过导管大动脉植入术 (TAVI) 患者的30天再入院率和住院费用的影响.
- 为了确定所有原因再入院的预测因素,在多发性硬化症TAVI患者中.
主要方法:
- 利用2016-2019年全国再接收数据库 (NRD) 来识别使用ICD-10-CM代码的MS的TAVI患者.
- 分析了30天所有原因的再入院率作为主要结果,以及住院时间和总住院费用.
- 采用单变量和多变量后勤回归来评估住院结果并确定再接收预测因素.
主要成果:
- 在217,147名TAVI患者中,有2140名 (0.98%) 患有多发性硬化症.TAVI患有多发性硬化症的患者表现出更高的30天再入院率 (15.8%vs12.3%) 和更长的住院时间 (5.7vs4.3天).
- 患有多发性硬化症的TAVI患者的住院费用明显高 (55,157美元与50,239美元对比).
- 住院死亡率没有显著差异,但周末入院,非大都会医院入院,以及AFib/flutter,COPD,先前中风,CKD,ESRD和贫血等并发症与再入院率的增加有关.
结论:
- 在TAVI患者中,并发性多发性硬化与高回收率和增加总住院费用有关,有助于增加医疗保健负担.
- 需要进行进一步的研究,以探索这种患者队列中的住院结果和特定再录取预测因素.
- 这些发现强调了针对同时存在多发性硬化症的TAVI患者需要有针对性的管理策略.
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