在医疗保险受益人中使用WATCHMAN设备后的长期临床结果
Emily P Zeitler1, Boyang Bian2, Robert I Griffiths
1Dartmouth Health and The Dartmouth Institute, Lebanon, NH (E.P.Z.).
Circulation. Cardiovascular quality and outcomes
|October 4, 2024
概括
在WATCHMAN左心房尾闭塞后的长期结果显示,在老年,更生病的医疗保险患者中,死亡率和出血风险显著,但每年缺血性中风率相对较低.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 公共卫生 公共卫生
背景情况:
- 在临床试验之外,左心房尾闭塞 (LAAO) 的长期结果尚未得到充分确立.
- 现实世界的数据收集是为美国市场授权WATCHMAN设备的任务.
- 这项研究评估了LAAO后的医疗保险受益人的中风,出血和死亡率.
研究的目的:
- 评估WATCHMAN设备在大量现实世界医疗保险人口中的长期安全性和有效性.
- 为了确定重要患者子组的结果.
- 为市场后监测和临床决策提供数据.
主要方法:
- 对接受LAAO (2016年4月 - 2020年8月) 的65岁以上的医疗保险收费服务受益人的分析.
- 使用ICD-10和CPT代码进行患者识别和结果评估.
- 在5年的随访期内计算出死亡率,缺血性中风和严重出血的累积发病率.
主要成果:
- 48,763名WATCHMAN接受者 (平均年龄77岁) 的5年结果是:死亡率为44%,大出血为15%,缺血性中风为7%.
- 老年和脆弱患者的结局更糟糕,包括那些先前患有中风或出血的人.
- 与女性相比,男性患者的死亡率较高,但中风/出血率相似.
结论:
- 接受WATCHMAN的医疗保险受益者比试验参与者更老,更生病.
- 高长期死亡率和高出血率反映了患者群体的高风险特征.
- 每年缺血性中风的发生率仍然相对较低 (每年<1.5%).
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