在接受选择性血管外科手术手术的老年人中,长期存活率具有脆弱性
Cali E Johnson1, Peter G Beidler1, Xinyan Zheng2
1Division of Vascular Surgery, Department of Surgery, University of Utah Health, Salt Lake City, UT.
Journal of vascular surgery
|March 7, 2025
概括
接受选择性血管手术的脆弱的医疗保险患者长期死亡率显著上升. 在手术前确定脆弱性对于管理这些高风险个体的结果至关重要.
科学领域:
- 血管外科 血管外科
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 血管质量倡议脆弱性指数 (VQI-FI) 是为了评估进行血管手术的患者的死亡风险而开发的.
- 在不同的医疗保险人群中验证VQI-FI对于其临床实用性至关重要.
研究的目的:
- 验证VQI-FI在接受选择性血管手术的医疗保险受益人中预测长期死亡率的能力.
- 评估脆弱程度 (使用VQI-FI) 与1年和5年死亡率之间的关联.
主要方法:
- 使用了VISION VQI-Medicare链接数据库 (2010-2019),其中包括109,400名患者.
- 根据VQI-FI得分分层分患者为非脆弱,轻度脆弱和中度至重度脆弱群体.
- 使用卡普兰-梅尔和考克斯比例危险模型分析了1年和5年死亡率.
主要成果:
- 15%的患者被确定为脆弱 (13%轻度,2%中度至重度).
- 脆弱的患者更有可能来自少数民族,非健行医疗和护理机构居民.
- 轻度和中度至重度的虚弱都与1年和5年死亡率的增加显著相关,五年死亡率的危险比分分别为2.7和5.9.
结论:
- 接受选择性血管手术的脆弱的医疗保险受益人长期生存率明显较差.
- VQI-FI有效地识别了长期死亡风险增加的患者.
- 在手术前确定脆弱性对于风险分层,干预计划和确定患者期望至关重要.
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