机械血栓切除 vs 导管导向血栓溶解 vs 单独用于肺栓塞的抗凝血药物的成本分析
Zein Kattih1, Simon Meredith1, Vincent Dong2
1Department of Pulmonary and Critical Care Medicine, Lenox Hill Hospital/Northwell Health, 100 E 77th St, NY, NY 10075, USA.
The American journal of the medical sciences
|July 7, 2025
概括
针对肺栓塞 (PE) 的机械血栓切除术 (MT) 产生比其他治疗方法更高的每例收入. 虽然先进的PE疗法具有更高的成本,但它们可能提供需要进一步研究的长期优势.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 卫生经济学 卫生经济学
背景情况:
- 肺栓塞 (PE) 是美国心血管死亡的主要原因,造成了大量的医疗保健费用.
- 有限的数据存在,比较高级肺栓塞治疗方式的成本效益.
研究的目的:
- 为了比较不同肺栓塞治疗策略之间的每病例收入.
- 分析肺栓塞干预措施的成本效益和资源利用情况.
主要方法:
- 从第三级中心的PERT注册表中,对2016-2023年期间为肺栓塞治疗的患者进行了回顾性分析.
- 仅使用抗凝剂,导管血栓溶解 (CDT) 和机械血栓切除 (MT) 的比较,根据每例收入.
- 评估二次结果,包括ICU利用率,生存率和再接收率.
主要成果:
- 机械血栓切除术 (MT) 的每例收入中位数最高 (59,058美元),与单独的CDT (19007美元) 和抗凝药 (16171美元) 相比.
- 与CDT (100%) 相比,MT (24%) 的ICU利用率显著较低,与单独抗凝药 (20%) 相比,CDT的利用率相当.
- 没有观察到停留时间,生存率或90天再接收率的显著差异,但MT消除了CTEPH发病率.
结论:
- 机械血栓切除术 (MT) 与肺栓塞治疗的抗凝固药和导管导向血栓溶解 (CDT) 相比,显示出更高的每例收入.
- MT显示了良好的ICU利用率,并可能预防慢性血栓栓塞性肺高血压 (CTEPH).
- 尽管初始成本较高,但先进的PE疗法可能会带来长期益处,这需要进一步研究.
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