大动脉吐患者的临床旅程:来自多中心数据库的回顾性观察研究
Nicholas S Amoroso1, Rahul P Sharma2, Philippe Généreux3
1Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
概括
现实数据显示,中度至重度大动脉吐 (AR) 患者的心脏门团队评估和大动脉置换 (AVR) 率较低. 未经治疗的严重AR显著增加了2年死亡率,突出显示了早期干预的必要性.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 健康 结果 研究 研究 结果
背景情况:
- 关于大动脉反 (AR) 管理和结果的现实数据有限.
- 了解心脏门团队评估和对AR进行主动脉置换 (AVR) 的趋势至关重要.
- 评估未经治疗的AR患者的死亡率对于临床决策至关重要.
研究的目的:
- 评估心脏门团队评估和AVR的现实世界趋势,用于记录AR的患者.
- 为了确定不同程度的AR未经治疗的患者的死亡率.
- 识别AR患者护理途径中的潜在缺口.
主要方法:
- 利用了来自美国25个机构的100多万名成年患者的非身份化数据集 (2018年1月至2023年3月).
- 从心声回声学报告中根据AR严重程度对患者进行分类.
- 使用卡普兰-梅尔估计和日志等级测试分析了心脏门团队评估,AVR和全因死亡率的比率.
主要成果:
- 在845113名AR患者中,心脏门团队评估的两年率为中度至重度AR的43.5%,严重AR的65.4%.
- 两年AVR率为中度至重度AR的19.4%,重度AR的46.5%.
- 没有AVR的两年死亡率随着AR严重程度的增加而增加,严重的AR达到20.7%;探索性分析显示,未经治疗的中度和严重的AR与特定的左心室尺寸的死亡率相似.
结论:
- 中等或较大的AR与未经治疗的患者在2年内出现不良结果有关.
- 心脏组评估和AVR的低率表明可能需要更早的干预.
- 提前转诊到心脏门团队可能会改善中度或较大的AR患者的临床结果.
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