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机械血栓切除术和导管导向血栓溶解在中级风险肺栓塞中的成本比较
Anne Tran1, Catalin Toma2, Wissam Jaber3
1Penn Presbyterian Medical Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
概括
导管血栓溶解 (CDT) 和机械血栓切除 (MT) 对中等风险肺栓塞 (PE) 的医院费用相似. 成本差异受到实践变化的影响,而不是固有的治疗费用.
科学领域:
- 干预心脏病学 干预心脏病学
- 肺部医学 肺部医学
- 卫生经济学 卫生经济学
背景情况:
- 导管血栓溶解 (CDT) 和机械血栓切除 (MT) 是中等风险肺栓塞 (PE) 的首要皮肤间治疗方法.
- 以前的研究证实了它们的安全性和有效性,但成本影响尚不清楚.
- 本研究从医院的角度分析了CDT与MT的经济效益.
研究的目的:
- 对中等风险PE进行CDT和MT的成本效益分析.
- 评估这些穿皮疗法在医院治疗中的经济优势.
主要方法:
- 在3个学术中心 (2013-2021) 连续372名中等风险急性PE患者接受MT或CDT治疗的回顾性分析.
- 使用调整成本模型对两个治疗组之间的住院费用指数进行比较.
主要成果:
- 未经调整的分析显示,CDT与非显著的5120美元高于MT的成本有关,这是由于逗留时间更长的原因.
- 调整后的分析,考虑到混因素,使成本差异缩小到1351美元 (P=.71).
- 对于CDT或MT都没有明确的成本优势.
结论:
- 多中心成本分析表明CDT或MT在中等风险PE中没有最终的成本优势.
- 观察到的成本变化源于实践模式和机构差异.
- 未来的研究应该专注于减少PE患者停留时间和提高PE患者护理效率.
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