定义最佳的左心室辅助器件的短期结果可能会为程序质量评估提供洞察力
Jennifer A Cowger1, Ezequiel Molina2, Luqin Deng3
1Henry Ford Heart and Vascular Institute, Detroit, Michigan.
概括
左心室辅助装置 (LVAD) 植入后的不良事件显著影响生存率和生活质量. 通过中心特定的质量倡议来减少早期并发症是改善患者结果的关键.
科学领域:
- 心血管外科心血管外科
- 医疗器械技术 医疗器械技术
- 健康 结果 研究 研究 结果
背景情况:
- 在左心室辅助器件 (LVAD) 植入后的术后结果存在显著的变化.
- 需要一个全面的工具来评估死亡率,不良事件 (AE) 和患者报告的质量改善结果.
研究的目的:
- 为LVAD接收者开发和验证一个多维质量评分.
- 量化特定不良事件对死亡率和与健康相关的生活质量 (QOL) 的影响.
主要方法:
- 利用胸部外科医生协会的Intermacs注册表数据用于HeartMate 3 LVAD植入物 (2017-2024年).
- 应用了考克斯的比例危险模型来得出INTERMACS的死亡率的短期复合INSITE质量评分 (INSITE).
- 使用后勤回归来评估AE对180天后INSITE-QOL得分的影响.
主要成果:
- 在13,148名患者中,有33.4%的患者在180天内经历了AEs或死亡.
- 特定的AE如中风,透析,呼吸衰竭,再手术和右心衰竭显著增加了死亡率和降低了QOL.
- 平均INSITE和INSITE-QOL分数为0.0,表明许多中心需要改进.
结论:
- 在LVAD植入后的不良事件对死亡率和QOL都有差异性和显著的影响.
- 针对早期并发症减少的中心特定质量改进计划提供了最实质性的机会,以提高长期生存率和患者的QOL.
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