通过导管心脏干预后的急诊室访问:系统性审查和元分析
Nathan G Best1,2, Marienell Talla1,2, Farnaz Rafiee1,2
1Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada.
概括
过导管心脏手术后的急诊室访问很常见,发生率高达22%. 了解预测因素对于改善PCI和TAVI等干预后的患者护理至关重要.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 医院再入院是跨导管心脏干预的主要指标,但急诊室 (ED) 访问的评价较低.
- 过导管手术包括皮肤冠状动脉干预 (PCI),心房隔膜缺陷 (ASD) 关闭,卵孔 (PFO) 关闭和过导管大动脉干预 (TAVI).
研究的目的:
- 综合各种跨导管心脏手术后ED访问的发生率,原因,预测因素,成本和结果.
- 评估ED访问作为干预心脏病学的绩效指标的重要性.
主要方法:
- 在Embase和Medline数据库的系统文献搜索 (2004年1月 - 2024年7月).
- 关于ED访问结果的描述性摘要和对30天发病率的聚合后的元分析.
- 包括19项研究,其中9项正在进行元分析.
主要成果:
- 30天ED访问的发病率在PCI中从2.8%到22%,在TAVI中从4%到15.3%.
- 聚合30天ED访问的发病率为PCI的9%,TAVI的12%,具有显著的异质性.
- 有限的数据显示了各种风险因素,包括程序的紧急性,停留时间,性别,年龄和痴呆症.
结论:
- 经过透气管心脏干预后的ED访问频繁但不一致地报告.
- 需要进一步的研究来确定特定的风险因素,并充分了解ED访问的负担.
- 为了准确的绩效评估,需要对ED访问进行标准化报告.
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