复杂高风险指示PCI (CHIP-PCI):是否安全让培训人员作为主要操作员进行PCI?
Majd B Protty1, Saad Hasan2, Diluka Premawardhana2
1Sir Geraint Evans Cardiovascular Research Building, Cardiff University, Cardiff, South Glamorgan, UK.
Open heart
|January 30, 2025
概括
接受监督培训的研究员 (FIT) 可以安全地执行复杂的高风险指示皮肤冠状动脉干预 (CHIP-PCI) 作为主要操作员. 由监督FIT执行的CHIP-PCI的结果与顾问的结果相似,表明在标准培训中可行性.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医学教育 医学教育
背景情况:
- 复杂的高风险指定的皮肤穿透冠状动脉干预 (CHIP-PCI) 通常保留给经验丰富的顾问.
- 培训人员 (培训人员或FIT) 由于该程序固有的风险,通常受限于执行CHIP-PCI作为主要操作员.
研究的目的:
- 调查CHIP-PCI的结果是否在由监督的FIT执行时与作为主要运营商的顾问进行时有所不同.
- 评估CHIP-PCI程序中的FIT培训的安全性和可行性.
主要方法:
- 来自三家英国心脏中心 (2018-2022) 的2295例CHIP-PCI病例 (UK-BCIS CHIP得分≥3) 的分析.
- 在监督FIT和顾问初级操作员之间医院内主要不良心脏事件 (IH-MACCE) 的比较.
- 使用多变量逻辑回归模型来调整基线和程序特征.
主要成果:
- 监督FIT执行了36%的CHIP-PCI病例,通常具有较低的基线复杂性.
- 多变量分析显示,监督FIT和顾问运营商之间的IH-MACCE (OR 0.72,95%CI:0.34至1.51) 没有显著差异.
- 对于较高的CHIP分数 (4+和5+) 的敏感性分析也显示了可比的IH-MACCE.
结论:
- 在标准程序中,培训FIT作为CHIP-PCI的主要操作员是可行的和安全的.
- 相似的结果表明",伙伴"效应在监督程序中的好处.
- 这种方法支持将CHIP-PCI培训纳入心脏病学奖学金计划.
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