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Daniel J Friedman¹, Chengan Du², Sarah Zimmerman²

¹Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (D.J.F., S.V., A.S.K., J.P.P.).

Circulation. Cardiovascular interventions

|June 18, 2024

概括

更高的医院和医生WATCHMAN数量改善了左心房尾闭塞的成功. 新的WATCHMAN FLX设备显示出更好的结果和更少的音量-结果变化.

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:

对于许多心血管手术来说,已经建立了体积与结果的关系,指导了最小体积值.
对于左心房尾闭塞 (LAAO) 的手术体积和结果之间的特定关联仍然不太清楚.
这项研究调查了医院和医生的程序量对LAAO成功的影响.

研究的目的:

为了确定医院和医生体积之间的关系,以及WATCHMAN左心房尾闭塞手术的成功.
为了评估这个关系,专门用于WATCHMAN FLX设备.

主要方法:

从国家心血管数据注册局LAAO注册局 (2019年1月至2021年10月) 分析了87,480个WATCHMAN程序.
利用三级层次的层次统一的通用线性模型来评估调整的关系.
程序成功被定义为设备释放,周围设备泄漏<5毫米,没有医院内重大不良事件.

主要成果:

693家医院的整体程序成功率为94.2%.
较低的医院体积 (Q1,Q2) 与较高体积四分位数 (Q4) 相比,与明显较低的程序成功相关.
与Q4相比,较低的医生体积 (Q1,Q2,Q3) 也与减少的程序成功有显著的关联.
在WATCHMAN FLX设备显示减弱的体积-结果关系与适度的结果差异在体积四分位数.

结论:

对于WATCHMAN手术来说,医院和医生数量的增加与手术成功的增加有关.
过渡到WATCHMAN FLX设备与改善的程序成功和减少在体积级别的结果变化相关.
了解设备特定的体积-结果关系对于优化左心房尾闭塞程序至关重要.

关键词:

医院医院医院医院左心房附属体的关闭闭关闭线性模型是一种线性模型.医生是医生,医生是医生登记处登记处登记处登记处

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