同时的左心房关闭的利用,成本和结果的时间趋势,在全州范围内的协作合作中
Yas Sanaiha1, Bob Kiaii2, Jack C Sun3
1Division of Cardiac Surgery, University of California Los Angeles, Los Angeles, Calif.
JTCVS open
|March 10, 2025
概括
在心脏手术期间,左心房尾关闭率 (LAAC) 正在上升. 然而,LAAC在妇女和紧急病例中不太常见,对短期死亡率没有重大影响,但成本增加.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 心房的发生率正在增加,使左心房尾关闭 (LAAC) 在心脏手术中成为关键的辅助.
- 左心房尾排除 (LAAE) 的利用,资源影响和差异需要描述.
研究的目的:
- 分析心脏手术期间LAAC的趋势和资源利用情况.
- 为了确定与LAAC相关的患者和操作因素.
- 评估LAAC的成本效益和短期成果.
主要方法:
- 利用胸腔外科医生协会数据库 (2015-2021) 对接受冠状动脉和门手术的成年患者同时进行LAAC.
- 采用多层次层次的物流建模来识别与LAAC相关的因素.
- 应用于风险调整增量成本分析的通用线性模型.
主要成果:
- 在8699名患者中,年度LAAC率从16.7%增加到30.8% (P<.001).
- LAAC与老年患者有关,但与胰岛素依赖糖尿病或透析相关的情况较少.
- 女性性别,重复和紧急状态显示LAAC的几率较低;对30天死亡率/再入院没有显著影响,但成本增加了10,602美元.
结论:
- LAAC的利用正在增加,但在女性和紧急干预患者中未得到充分利用.
- 根据LAAC的研究,没有显著的短期死亡率影响.
- 对于特定的患者群体来说,LAAC可能是一个高价值的干预措施.
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