地理和社会经济差异在透气管后的大动脉置换,心脏起器安置,心脏起器安置
Bilal Hussain1, Sanchit Duhan2, Ahmed Mahmood3
1Internal Medicine, The Brooklyn Hospital Center, Brooklyn, NY, United States of America.
概括
地理位置,而不是患者人口统计,影响了经过透气管大动脉置换 (TAVR) 后心脏起器植入的风险. 中大西洋医院显示,TAVR后心脏起器手术的风险最高.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
- 医疗器械 医疗器械
背景情况:
- 过导管大动脉置换 (TAVR) 是对大动脉狭窄的常见手术.
- 需要心脏起器 (PPM) 植入的导电异常可能发生在TAVR后.
- 基于医院地理和患者社会经济地位的TAVR后PPM率的差异尚未得到充分理解.
研究的目的:
- 调查TAVR之后心脏起器植入率的地理和社会经济差异.
- 确定与TAVR后PPM风险增加相关的因素.
主要方法:
- 国家住院患者样本 (2016-2020年) 的回顾性队列分析.
- 使用了TAVR和PPM植入的ICD-10代码.
- 使用加权多变量逻辑回归来分析结果.
主要成果:
- 共有296,740名患者接受了TAVR,PPM植入率为9.5% (28,265名患者).
- 患者人口统计学 (性别,种族,收入,保险) 除了年龄之外,与PPM风险没有显著关联.
- 与农村医院相比,城市非教学医院的PPM风险更高 (OR 2.09).
- 与新英格兰 (OR 1.54) 相比,中大西洋医院的PPM风险最高,其次是太平洋,山区和东北中部地区.
结论:
- 年龄是与TAVR后PPM风险相关的主要人口因素.
- 在TAVR后的PPM率存在显著的地理差异,中大西洋医院的风险最高.
- 需要进一步的研究来探索TAVR等待时间,人员专业知识和程序后管理,以了解区域结果的差异.
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