下静脉卡瓦 (IVC) 过器检索率的变化和遵守指南:多中心追溯分析
Zachary Nuffer1, Phil Ramis2, Eric M Rohren1
1Department of Radiology, Baylor College of Medicine, Baylor St. Luke's Medical Center, 1101 Bates Ave., Houston, TX 77030, USA.
Journal of clinical medicine
|June 26, 2025
概括
下腔静脉 (IVC) 过器的检索率在各医院之间有很大差异,许多医院未能满足及时清除指南. 这凸显了质量改善的关键需求,以减少并发症和改善患者的治疗结果.
科学领域:
- 血管外科 血管外科
- 干预性放射学 干预性放射学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在无法使用抗凝药的患者中,下静脉 (IVC) 过器可以预防肺栓塞 (PE).
- 临床指南主张及时检索IVC过器,但目前的速率低于最佳水平.
- 低于最佳的检索引发了对长期过器相关并发症的担忧.
研究的目的:
- 分析IVC过器检索率在国家医院一级的变化.
- 评估IVC过器移除推时间的遵守情况.
- 确定与检索实践相关的设施特定因素.
主要方法:
- 美国158个医院的12197名患者的回顾性分析 (2020-2024年).
- 检索率的评估,检索时间,以及与程序量和学术关系的相关性.
- 使用了描述性统计和相关性分析.
主要成果:
- 设施检索率表现出很大的差异 (0.36%至100%,平均23%).
- 只有43%的过器在建议的90天内被检索出来.
- 检索率和手术量/患者年龄之间观察到微弱的负相关性;学术/非学术设施之间没有显著差异.
结论:
- 在全国范围内,IVC过器检索实践存在显著的变化.
- 许多设施不符合及时清除过器的基准.
- 有针对性的质量改进举措是必要的,以提高检索遵守率和患者安全.
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