慢性疾病和以患者为中心的结果经过过导管大动脉干预后的慢性疾病和以患者为中心的结果
Benjamin S Wessler1, Amanda Stebbins2, Mohamad Alkhouli3
1Division of Cardiology, Cardiovascular Center at Tufts Medical Center, Boston, Massachusetts, USA.
JACC. Advances
|October 18, 2025
概括
过导管大动脉干预 (TAVI) 改善了大动脉狭窄患者的生活质量,即使是那些患有多重慢性疾病 (MCC) 患者. 虽然MCC与更高的死亡率有关,但TAVI仍然提供了显著的健康益处和生存益处.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 抚慰性护理是一种缓解性护理.
背景情况:
- 过导管大动脉干预 (TAVI) 已经改变了对患有大动脉狭窄症的老年人的护理.
- 多重慢性疾病 (MCC) 对TAVI结果的影响需要进一步调查.
研究的目的:
- 分析TAVI后慢性疾病和患者结局之间的关联.
- 为了确定TAVI患者的息护理服务的利用率.
主要方法:
- 一项队列研究使用了与CMS索赔数据相关联的STS/ACC TTVT注册表.
- 接受TAVI的患者在手术前一年被评估MCC.
- 多变量逻辑回归分析了慢性疾病和结果之间的关系.
主要成果:
- 分析了188,629个TAVI手术;中位数年龄为82岁.
- 多重冠状病毒与增加1年死亡率 (aHR:2.33) 和较低的基线生活质量有关.
- 在TAVI后,生活质量的改善是显著的,并且独立于慢性疾病负担.
结论:
- 慢性疾病与TAVI后的生存率较差有关,但观察到显著的生活质量提高.
- 这些发现为具有复杂健康状况的TAVI患者的预期结果提供了关键的见解.
- 息护理的利用率很低 (4.7%),并且在治疗中心之间存在很大差异.
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