感染性内动脉瘤住院治疗的干预方式趋势:全国性的分析
Giana Dawod1, Alis J Dicpinigaitis1, Cenai Zhang1
1Clinical and Translational Neuroscience Unit, Department of Neurology and Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA.
概括
感染性内动脉瘤的治疗转向了内血管方法,整体干预率或患者死亡率没有变化. 这一趋势没有对结果产生不利影响.
科学领域:
- 神经外科 神经外科
- 传染性疾病 传染性疾病
- 血管外科 血管外科
背景情况:
- 传染性内动脉瘤 (IIA) 是传染性内心炎的罕见但严重的并发症.
- 对IIAs的最佳治疗策略仍未完全定义.
- 脑血管疾病的管理越来越多地结合了内血管技术.
研究的目的:
- 分析内血管和神经外科治疗IIA的趋势.
- 调查治疗方式对患者结果的影响.
主要方法:
- 全国住院患者样本 (2000-2019年) 的回顾性分析.
- 在传染性内心炎的背景下,鉴定IIA的住院情况.
- 使用ICD代码将治疗方法分为内血管和开放的神经外科修复.
- 后勤回归用于评估治疗方式与住院死亡率和出院处置的关联.
主要成果:
- 确定了24461例因IIA而入院的病例.
- 整体干预率保持在5.8%的稳定水平.
- 内血管修复率显著增加 (APC=3.6%),而开放的神经外科修复率显著下降 (APC=-5.4%).
- 治疗方式没有显著影响住院死亡率或非家庭出院.
结论:
- 虽然IIA的整体干预率没有变化,但从开放的神经外科手术到内血管治疗发生了显著的转变.
- 这种治疗方式的转变没有对死亡率或出院处置产生不利影响.
- 未来的研究应该专注于确定有利结果和最佳程序时间的预测因素.
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