用于缺血性中风的诊断减去血管学 (美国DUTCH研究) 医疗保险受益者之间的区域变化和时间趋势
Maxim J H L Mulder1, Diederik W J Dippel1, James Burke2
1Erasmus University Medical Center, Rotterdam, The Netherlands.
概括
数字减去血管造影 (DSA) 很少用于缺血性中风患者,从2016年到2020年,病率没有变化. 在DSA表现方面存在显著的医院变化,并不能完全由患者或设施因素解释.
科学领域:
- 神经学 神经学
- 血管成像 血管成像
- 脑卒中医学 脑卒中医学
背景情况:
- 目前没有指导方针推数字减去血管造影 (DSA) 治疗缺血性中风.
- 了解DSA利用趋势和影响因素对于优化中风护理至关重要.
研究的目的:
- 为了研究在缺血性中风患者中使用DSA的速度.
- 分析最近的时间趋势,医院变化和DSA表现的相关因素.
主要方法:
- 对患有缺血性中风 (2016-2020) 的医疗保险受益人的回顾性横截面研究.
- 使用ICD-10代码进行诊断,以及用于血栓切除和DSA的程序代码.
- 分析了医院趋势和与DSA能力的医院中DSA表现相关的因素.
主要成果:
- 在1,085,644名缺血性中风患者中,DSA在0.7%进行.
- 与DSA相关的因素包括年轻的年龄,更高的医院血栓切除率,患者转移和动脉疾病.
- 观察到DSA率在医院有显著的变化 (0.07%至11.1%),其中15%归因于医院倾向.
- 在研究期间,DSA的发病率没有变化.
结论:
- 数字减去血管造影在急性缺血性中风管理中很少使用.
- 在2016年至2020年期间,DSA利用率保持稳定.
- DSA使用的实质性医院水平变化仍然存在,超过了患者和设施特征的解释.
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