在第三级医院接受动脉血管手术的患者的术前评估概况
Arthur Souza Magnani1, Leandro Teixeira de Castro2, Isabela Cristina Kirnew Abud Manta2
1Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
心脏病学家对接受动脉手术的患者进行了更多的测试,但这并没有减少主要心脏不良事件 (MACE) 或死亡率. 然而,它确实增加了住院时间,这表明需要优化资源.
科学领域:
- 心血管外科心血管外科
- 血管外科 血管外科
- 心脏病学 心脏病学
背景情况:
- 患有外周动脉疾病的患者面临心血管并发症的风险增加,包括主要心脏不良事件 (MACE),动脉手术后.
- 术前评估对于缓解MACE和死亡率至关重要,但缺乏标准化.
- 这项研究调查了全科医生对心脏病学家进行手术前评估的影响.
研究的目的:
- 为了比较一般医生对心脏病学家进行的动脉手术患者手术前评估的有效性和结果.
- 评估评估者类型对MACE发病率,死亡率和资源利用的影响.
主要方法:
- 在2016年1月至2020年12月期间,对281名接受选择性动脉手术的患者进行了回顾性分析.
- 一般医生和心脏病学家进行的手术前评估的比较,分析临床因素,MACE,死亡率和测试要求.
- 评估非侵入性分层测试率,住院时间和其他相关结果.
主要成果:
- 心脏病专家要求的非侵入性分层测试 (40.8%) 比全科医生 (9%) 多得多.
- 两组之间死亡率 (8.8%与10.7%) 或术后MACE发病率 (10.6%与6.2%) 没有显著差异.
- 由心脏病专家评估的患者住院时间较长 (17.27天),而一般医生住院时间较长 (11.79天).
结论:
- 增加心脏病学家的非侵入性检测并没有改善动脉手术患者的死亡率或MACE的结果.
- 较高的检测率导致长时间住院,影响了资源利用率.
- 研究结果表明,卫生管理人员需要优化资源配置,并确保适当的手术前评估策略.
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