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教科书中的性别差异成年人接受选择性腹腔大动脉动脉瘤修复的结果
Amanda C Filiberto1, C Adam Banks, Angela Sickels
1From the Division of Vascular Surgery and Endovascular Therapy, University of Alabama, Birmingham, AL.
Journal of the American College of Surgeons
|March 3, 2025
概括
腹腔大动脉动脉瘤 (AAA) 的女性在修复后不太可能达到教科书结果 (TOs). 然而,在AAA修复中实现TOs消除了两性之间的生存差异,突出了其对质量改善的重要性.
科学领域:
- 血管外科 血管外科
- 医疗保健服务研究 医疗服务研究
- 医学中的性别差异.
背景情况:
- 与男性相比,腹腔大动脉动脉瘤 (AAA) 的女性患者在修复后表现较差.
- 教科书成果 (TOs) 作为AAA修复中质量改善和机构绩效评估的关键指标.
研究的目的:
- 为了调查基于性别的差异在实现教科书结果 (TOs) 后开放性大动脉动脉瘤修复 (OAR) 和内血管大动脉动脉瘤修复 (EVAR).
- 通过TO成绩分层的性别来比较患者人口统计学,结果和1年生存率.
主要方法:
- 对80948名接受选择性AAA修复的患者的血管质量倡议注册数据的分析.
- TO的定义是没有重大并发症,长时间住院,重新介入,死亡率和非家庭出院.
- 单独分析了EVAR和OAR队列,按TO和性别分层.
主要成果:
- 在EVAR (80%对67%) 和OAR (54%对47%) 中,男性比女性更频繁地达到TO.
- 女性实现TO的主要障碍包括术后长时间停留,手术并发症和非家庭出院.
- 对EVAR和OAR来说,TO与1年生存率的改善有关;对接受OAR的男性来说,高体积中心与TO有关.
结论:
- 妇女在AAA修复中经历了较低的TO率,无论手术方法如何.
- 在AAA修复中实现TO消除了女性的生存劣势,强调了其作为质量标准的作用.
- 实施TO作为质量指标可以帮助减轻AAA修复结果中的性别差异.
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