适应性心脏再同步治疗算法的使用与医疗保健的使用和成本之间的关联
Michael R Gold1, Jiani Zhou2, Lucas Higuera2
1Medical University of South Carolina, Charleston, SC.
Journal of cardiac failure
|July 8, 2024
概括
适应性心脏再同步疗法 (aCRT) 在现实患者中显著降低了死亡率和医疗保健使用率. 这种自适应步调方法也降低了付款人和患者的成本.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 卫生经济学 卫生经济学
背景情况:
- 适应性心脏再同步治疗 (aCRT) 算法在子组分析中显示了先前的临床益处.
- 一项大型前性试验在死亡率或心力衰竭住院治疗方面产生了无意义的结果.
研究的目的:
- 评估适应性节奏与心脏再同步治疗 (CRT) 接受者的临床/经济结果之间的关联.
- 评估自适应性双心室和左心室节奏 (aCRT) 与标准CRT的实际有效性.
主要方法:
- 来自Optum Clinformatics数据库的2412名aCRT和1638名标准CRT患者的回顾性分析,随访时间≥90天.
- 基于aCRT与标准CRT的远程监控数据进行分类.
- 用于调整基线差异的治疗权重的逆概率.
主要成果:
- 该aCRT组显示出较低的全因死亡率 (aHR=0.88) 和30天再入院率 (aIRR=0.87).
- aCRT与所有原因和心力衰竭的住院,门诊和急诊室访问较少有关.
- 在aCRT队列中观察到较低的付款人和患者费用,用于所有原因和心力衰竭相关的护理.
结论:
- 适应性CRT在现实世界队列中的使用与降低死亡率有关.
- 适应式CRT与医疗保健资源利用率的降低有关.
- 适应性节奏策略导致付款人和患者的成本降低.
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