在区域推中心对无复杂的B型大动脉解剖进行成像监测的遵守
Griffin P Stinson1, Jonathan R Krebs1, Liam R Kugler1
1Division of Vascular and Endovascular Therapy, Department of Surgery, University of Florida College of Medicine, Gainesville, FL.
Annals of vascular surgery
|December 13, 2024
概括
对无并发性B型大动脉解剖 (uTBAD) 的成像监测的遵守率很低,家庭出院的遵守率越来越高. 诸如先前的心血管手术和药物使用史等因素与较低的坚持率有关.
科学领域:
- 心血管外科心血管外科
- 医疗成像医学成像
- 公共卫生 公共卫生
背景情况:
- 医疗管理和成像监测是B型无并发性主动脉解剖 (uTBAD) 的标准.
- 不遵守监测可以导致大动脉退化,并发症和死亡率增加.
- 这项研究旨在评估对成像监测的遵守情况,并确定相关的风险因素.
研究的目的:
- 分析B型无并发性大动脉切割 (uTBAD) 患者对成像监测的坚持率.
- 确定与不遵守监测协议相关的人口,临床和后勤因素.
- 评估监测对患者结果和干预措施的影响.
主要方法:
- 一项回顾性队列研究分析了152名急性或亚急性uTBAD患者.
- 图像监测被定义为大动脉定向成像和住院后≥3个月的遭遇.
- 单变量和多变量后勤回归确定了与监视遵守相关的因素.
主要成果:
- 只有46%的患者接受了推的成像监测.
- 坚持不与患者的人口统计或距离中心的距离相关.
- 家庭出院与较高的坚持有关,而先前的心血管手术,药物使用史和年龄较大与较低的坚持有关.
- 接受监测的患者更有可能接受放出后胸腔内血管大动脉修复 (TEVAR).
结论:
- 观察到对uTBAD成像监测的遵守率较低,独立于患者特征或地理距离.
- 虽然监测与TEVAR的增加有关,但两组之间5年生存率相似.
- 家庭出院成为促进监测遵守的关键因素,突出了医疗管理的 uTBAD 护理协调方面的挑战.
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