等待时间和心房后移除结果之间的关系:基于人口的研究
Denis Qeska1, Feng Qiu2, Ragavie Manoragavan3
1Schulich Heart Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada; Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Heart rhythm
|April 12, 2024
概括
从心房 (AF) 诊断到导管切除的较长时间增加了不良结果. 然而,从转诊到切除的时间并没有影响成功率. 卫生系统可以通过减少诊断到切除的延迟来改善AF管理.
科学领域:
- 心脏病学 心脏病学
- 医疗信息学 医疗信息学
背景情况:
- 节律控制对于管理心房动 (AF) 是至关重要的.
- 从AF诊断到导管切除的时间较短与更好的治疗成功相关.
- 之前的研究没有充分考虑患者的风险概况.
研究的目的:
- 评估诊断到切除和转诊到切除时间对管切除后结局的影响.
- 分析AF切除后治疗延迟和患者预后之间的关系.
主要方法:
- 在加拿大安大略省 (2016-2022) 进行了对7472名因新发肺炎而接受导管切除的患者的观察性队列研究.
- 收集的数据包括人口统计,并发症和关键日期 (诊断,转诊,切除).
- 主要结局:死亡和住院/ED访问因AF,心力衰竭或1年内缺血性中风的组合,使用多变量Cox模型进行分析.
主要成果:
- 诊断到切除的中位数时间为718天;中位数转诊到切除的时间为221天.
- 12.2%的患者在1年内经历了复合终点.
- 每个月增加的诊断到消去时间都与初级结局的风险增加有关 (HR1.02;95% CI1.01-1.02).
- 推到消去的时间对主要结果没有显著影响 (HR 1.00;95% CI 0.98-1.01).
结论:
- 在AF诊断和切除转诊之间的延迟与不良的术后结果有关.
- 这些发现突出了改善卫生系统 AF 管理质量的机会.
- 专注于缩短诊断至切除的间隔可能会改善患者的治疗结果.
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