隔离性大动脉 insufficiency 的医疗负担
Ibrahim Sultan1, Michael Ryan2, Candace Gunnarsson3
1Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh and Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Scientific reports
|February 8, 2025
概括
有症状的隔离性大动脉衰竭 (AI) 患者比无症状的AI患者面临更高的死亡率,医疗保健使用率和成本. 早期检测和干预至关重要,因为无症状的人工智能可以迅速发展.
科学领域:
- 心脏病学 心脏病学
- 卫生经济学 卫生经济学
- 临床结果研究研究
背景情况:
- 隔离性大动脉缺陷 (AI) 是一种重要的心血管疾病.
- 了解症状和无症状AI之间的结果差异对于患者管理至关重要.
- 当前的文献可能无法完全捕捉与不同AI呈现相关的长期医疗负担.
研究的目的:
- 为了比较症状隔离大动脉缺陷 (SAI) 和无症状隔离大动脉缺陷 (AAI) 的患者之间的死亡率,医疗保健利用率和成本.
- 分析AAI向症状性疾病的进展.
- 为临床实践提供有关AI管理的信息.
主要方法:
- 使用Optum联合医疗保健数据库 (2017-2022) 进行的回顾性队列研究.
- 包括美国患者的AI索赔和12个月的预诊断入学.
- 排除以前进行过大动脉置换 (AVR) 或大动脉狭窄症的患者.
- 基线上AI相关症状的存在 (SAI) 或不存在 (AAI) 定义的队列.
- 分析结果:全因死亡率,家庭健康/SNF的时间,年度医疗保健利用率和成本.
- 统计分析:死亡率的Cox比例模型,利用和成本的一般线性模型.
主要成果:
- 总共分析了249,660名AI患者.
- 58.23%的患者出现了症状 (SAI).
- 与AAI患者相比,SAI患者年龄更大,病情更严重,死亡率,医疗保健利用率和成本明显更高.
- 不到1%的患者接受了AVR.
- 估计50%的AAI患者在诊断后5年内可能会出现症状.
结论:
- 有症状的隔离性大动脉缺陷与比无症状疾病更糟糕的临床和经济结果有关.
- 从无症状到症状AI的快速进展强调了需要警监测的必要性.
- 强调早期检测和及时干预,包括手术选择,对于减轻人工智能的影响至关重要.
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