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JAHA：经导管主动脉瓣膜置换等待时间与术后早期结局之间的关系

2019-01-06 xing.T MedSci原创

经导管主动脉瓣膜置换等待时间术后早期结局
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由此可见，等待时间与术后结局之间有着复杂的关系，后者完全由紧急状态调节。这表明进一步的研究应该阐明在候补名单上的患者预测需要住院进行紧急TAVR治疗的因素。

经导管主动脉瓣置换术（TAVR）需求的快速增长已转化为医疗资源不足，这通过等待时间延长来反映。在候补名单上，等待时间的增加与重要的不良后果有关；然而，不知道延长的等待时间是否会影响术后结局。近日，心血管疾病领域权威杂志JAHA上发表了一篇研究文章，研究人员的目的是确定TAVR等待时间和术后结局之间的关联。

在加拿大安大略省进行的基于人群的研究中，研究人员确定了2010年4月1日至2016年3月31日期间所有接受TAVR的患者。等待时间定义为初次转诊和手术之间的天数。感兴趣的主要结局是30天的全因死亡率和全因再入院。多变量回归模型使用三次样条将等待时间作为非线性变量。

该研究队列纳入了2170例TAVR手术患者，其中1741例为择期手术患者，429例为紧急手术患者。TAVR等待时间与TAVR后30天死亡率以及30天再入院之间存在显著的非线性关系。研究人员观察到随着等待时间的增加风险增加，而随着等待时间缩短的风险降低。在未调整的模型中以及在调整临床变量之后，可以观察到这种统计学上显著的非线性关系。但是，在调整病例紧急状态后，等待时间与术后结局之间没有相关性。在仅限于择期或仅在紧急病例的敏感性分析中，等待时间与术后结局之间没有关系。

由此可见，等待时间与术后结局之间有着复杂的关系，后者完全由紧急状态调节。这表明进一步的研究应该阐明在候补名单上的患者预测需要住院进行紧急TAVR治疗的因素。

原始出处：

Gabby Elbaz‐Greener.et al.Association Between Wait Time for Transcatheter Aortic Valve Replacement and Early Postprocedural Outcomes.JAHA.2019.https://www.ahajournals.org/doi/full/10.1161/JAHA.118.010407

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    2019-01-18 yxch48

    #置换#

    0

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    2019-01-08 zhaohui6731

    #AHA#

    0

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    2019-01-08 hittouch

    #主动脉瓣#

    0

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    2019-01-08 circumcision

    #主动脉#

    0

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    2019-01-08 lsj631

    #经导管#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1742561, encodeId=34a61e425617c, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Fri Jan 18 05:36:00 CST 2019, time=2019-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268026, encodeId=6ea41268026fa, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Tue Jan 08 10:36:00 CST 2019, time=2019-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332601, encodeId=39291332601b1, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Tue Jan 08 10:36:00 CST 2019, time=2019-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415441, encodeId=2dd2141544105, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Tue Jan 08 10:36:00 CST 2019, time=2019-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510183, encodeId=724c1510183c3, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Tue Jan 08 10:36:00 CST 2019, time=2019-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583605, encodeId=949c1583605c4, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Tue Jan 08 10:36:00 CST 2019, time=2019-01-08, status=1, ipAttribution=)]
    2019-01-08 12498e5fm17(暂无昵称)

    #瓣膜#

    0