跨导管大动脉置换后医院死亡率和再入院率之间的关系
Dhaval Kolte1,2, Archana Tale2, Yang Song2
1Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
European heart journal. Quality of care & clinical outcomes
|December 14, 2024
概括
过导管大动脉置换 (TAVR) 后的医院死亡率和再入院率显示出微弱的相关性. 这表明不同的护理过程会影响每个结果,需要针对TAVR患者量身定制的干预措施.
科学领域:
- 心血管外科心血管外科
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高质量
背景情况:
- 在30天风险标准化死亡率 (RSMR) 和再入院率 (RSRR) 中存在显著的医院变化.
- 在TAVR后的医院RSMR和RSRR之间的关系仍然不太清楚.
研究的目的:
- 描述TAVR后医院30天RSMR和RSRR之间的关系.
- 为了研究这种关系在不同的医院特征中如何变化.
主要方法:
- 在512家医院 (2015-2020年) 进行TAVR的141,905名医疗保险收费服务受益人的分析.
- 利用层次逻辑回归来估计医院特定的RSMR和RSRR.
- 使用Pearson相关性和受限立方线回归来评估RSMR-RSRR关系.
主要成果:
- 医院RSMR中位数为2.2%,RSRR中位数为13.2%.
- 在TAVR后的30天RSMR和RSRR之间观察到较弱的整体相关性 (r=0.25).
- 最弱的相关性是在非JCAHO认证的医院,中西部/西部地区和低体积的TAVR中心中发现的.
结论:
- 在TAVR之后,医院死亡率和再入院率之间存在弱相关性.
- 这表明不同的医院实践影响死亡率与再入院率.
- 这两种结果都需要独立的测量和有针对性的干预措施来改善TAVR患者的护理.
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