在医疗保险受益者的胸前大动脉动脉瘤的成像监测
Roxanne S Steijn1,2, Hechuan Hou2, Nicholas S Burris3
1Reinier de Graaf Gasthuis, Delft, The Netherlands.
JTCVS open
|September 9, 2025
概括
胸前大动脉动脉瘤 (TAA) 的成像在医疗保险受益者中使用不足. 更频繁的成像与增加的手术干预和住院治疗有关,但死亡率较低.
科学领域:
- 心血管医学 心血管医学
- 医疗成像医学成像
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在临床实践中,指南推的胸前动脉动脉瘤 (TAA) 影像监测并未得到充分描述.
- 需要对TAA患者的成像频率,结果,程序和成本进行评估.
- 了解当前的TAA成像实践对于改善患者管理至关重要.
研究的目的:
- 评估TAA医疗保险受益人的成像程序的频率.
- 评估成像频率与临床结果之间的关联.
- 分析与TAA成像相关的医疗保健成本.
主要方法:
- 对28459名医疗保险受益者 (≥65岁) 的 TAA (2017-2019) 的回顾性队列研究.
- 分析住院患者和专业人士的要求,以确定成像类型 (CT,MRA,TTE) 和频率.
- 多变量后勤回归用于评估与成像相关的因素,并比较成像组之间的结果.
主要成果:
- 45.6%的受益者接受了成像检查;7.6%接受了≥3次成像检查.
- 年龄较小,女性性别,白人种族/种族以及较低的并发病率与接受成像检查有关.
- 与没有成像相比,≥3次成像程序与手术干预 (6.6%vs0.4%) 和住院治疗 (75.9%vs41.6%) 的增加相关,但死亡率降低 (13.3%vs16.4%).
结论:
- 胸前动脉动脉瘤 (TAA) 成像在医疗保险受益者中未得到充分利用.
- 增加成像频率与更高的手术干预和住院率有关.
- 更频繁的TAA成像与减少全因死亡率有关.
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