通过皮肤进行机械循环支持辅助的皮肤冠状动脉干预后的早期复诊:来自全国复诊数据库的见解
Sean DeAngelo1, Badri Aryal1, Gianfranco Bittar-Carlini1
1Department of Internal Medicine, John H Stroger Jr. Hospital of Cook County, Chicago, IL, USA.
概括
皮肤机械循环支持 (pMCS) 辅助皮肤冠状动脉干预 (PCI) 再入院发生在15.6%的患者中,高血压心脏病和NSTEMI是常见的原因. 识别高风险患者对于降低再入院和医疗保健成本至关重要.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 通过皮肤进行的机械循环支持 (pMCS) 辅助的通过皮肤冠状动脉干预 (PCI) 的使用增加了.
- 临床预测因素和对再接收率的影响仍然不清楚.
- 需要评估心血管病因,死亡率和pMCS辅助PCI后再接收的预测因素.
研究的目的:
- 评估pMCS辅助PCI后30天再入院的心血管原因.
- 确定与这些再入院相关的死亡率和临床预测因素.
- 为了比较心脏性休克患者与接受pMCS辅助PCI患者的结局.
主要方法:
- 全国大规模再接收数据库的分析 (2016年1月 - 2020年11月).
- 包括接受pMCS (IABP,Impella,PVAD) 和PCI的患者.
- 评估ICD-10代码的再接收原因,死亡率,住院时间和医院费用.
主要成果:
- 77,099名患者中有15.6%的患者在30天内重新入院;重新入院者中有7.26%的死亡率.
- 常见的再入院原因:高血压心脏病与心力衰竭 (8.6%),高血压心脏和慢性病 (8.3%),NSTEMI (4.1%).
- 再入院的预测因素包括女性性别,违背医疗建议离开,功能不全,心血管不全,先前的门置换和长时间的LOS.
结论:
- 15.6%的患者在pMCS辅助的PCI后经历了30天的再入院,死亡率显著.
- 高血压性心脏病和NSTEMI是重招的主要驱动因素.
- 需要针对高风险患者进行有针对性的干预和密集的随访,以减少再入院和成本.
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