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集中护理对美国大动脉剖析结果的影响
Patrick D Conroy1, Besher Tolaymat1, Alec Schubert1
1Department of Vascular and Endovascular Surgery, Cooper University Hospital, Camden, NJ; Office of Medical Education, Cooper Medical School of Rowan University, Camden, NJ.
Journal of vascular surgery
|October 9, 2025
概括
大动脉剖析 (AD) 的住院病例有所增加,更多病例在城市教学医院得到治疗. 在这些中心集中复杂的大动脉护理显示出潜在的死亡率好处.
科学领域:
- 心血管外科心血管外科
- 医疗保健服务研究 医疗服务研究
- 流行病学 流行病学
背景情况:
- 医院系统已经发展,将复杂的护理集中在城市教学医院.
- 大动脉解剖 (AD) 的干预指南已经发展,有利于最少的侵入性治疗.
研究的目的:
- 检查20年来AD住院,干预和医院特征的趋势.
- 为了阐明集中护理对AD结局的影响.
主要方法:
- 从国家住院患者样本 (2000-2021) 中分析了553,030例AD住院病例.
- 检查开放式修复,内血管修复和医疗管理趋势.
- 按医院环境分层 (城市教学,城市非教学,农村) 来比较干预和死亡率.
主要成果:
- 阿尔茨海默病的发病率从每10万人口中的26.7增加到每10万人口中的47.2.
- 内血管修复变得越来越常见,特别是在下降的AD (2021年为85%).
- 阿尔茨海默病的管理越来越多地发生在城市教学医院 (72%-92%),与农村同行相比,死亡率较低.
结论:
- 大动脉剖析住院和干预的数量显著增加.
- 城市教学中心的护理区域化是显而易见的,有建议的死亡率好处.
- 需要进一步的研究来证实集中主动脉护理对死亡率的好处.
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