影响EVAR后成像监测的因素:改善的机会
Daniel Gage1, Drayson B Campbell2, Michael R Go2
1Department of General Surgery, The Ohio State University, Columbus, OH 43210, USA.
血管内主动脉修复 (EVAR) 后对成像监测的坚持随着时间的推移而下降,影响内泄漏检测. 住得更远的患者不太可能遵守随访时间表.
科学领域:
- 血管外科 血管外科
- 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:
- 血管外科学会 (SVS) 的指导方针建议在血管内主动脉修复 (EVAR) 后进行成像监测,以监测患者.
- 遵守这些后续协议对于检测诸如内脏泄漏等并发症至关重要.
- 这项研究研究了粘附趋势及其对EVAR后内泄漏检测的影响.
研究的目的:
- 在EVAR之后评估遵守SVS成像监测指南.
- 为了确定粘附度,EVAR后的时间和内泄漏检测之间的关系.
- 为了确定与不遵守后续成像相关的因素.
主要方法:
- 在2014-2022年期间,对395名接受EVAR治疗的患者进行了回顾性队列研究.
- 通过遵守SVS成像建议分层的患者,术后长达五年.
- 多变量物流回归分析了包括距离设施的距离和区域贫困指数 (ADI) 在内的因素.
主要成果:
- 只有44%的患者遵守了所有成像建议,平均每年随访损失为9.7%.
- 在研究期间,在15.4%的患者中检测到II型内皮泄漏.
- 居住距离机构50英里以上是一个独立的不遵守的风险因素 (OR1.76,p=0.018).
结论:
- 随着时间的推移,遵守EVAR监控指南的程度逐渐下降,但几年后仍然可以检测到内脏泄漏.
- 虽然距离对坚持影响,但患者的区域剥夺指数没有显示出显著的关联.
- 医疗保健提供者可以在提醒患者和促进后续成像预约中发挥作用,以改善遵守.
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