Heart:高容量与低容量医疗中心的经导管主动脉瓣植入结局

2020-03-04 xiangting MedSci原创

每年每个中心最少要进行50例手术足以确保足够的常规手术量,从而改善院内结局,并确保了TAVI手术在全国范围内的覆盖。

经导管主动脉瓣植入术(TAVI)是德国最常见的主动脉瓣置换术。自2015年以来,为了确保高质量的手术,满足每个中心最少50例介入手术要求的德国和其他国家医院被认证可以进行TAVI。这项研究分析了这些要求对病例数和住院结局的影响。

通过国际疾病分类(ICD)和德国手术分类代码查找2008年至2016年间的所有单纯TAVI手术和住院结局。

2008年至2016年间,德国进行了73467例经股动脉和经心尖的单纯TAVI手术。在此期间,每年的TAVI手术量急剧上升,而医院死亡率和并发症的总体发生率却下降了。2008年,大部分手术(54.63%)在每年手术量不到50例的医院进行。直到2014年,在低容量医疗中心治疗的患者比例一直下降到5.35%。指南修订后,这一比例进一步降至1.99%。在引入病例数最低要求的2年后,在高容量中心接受治疗患者的院内死亡风险降低(风险调整后的OR0.62p=0.012)。风险调整后,其他院内结局(卒中、永久性起搏器植入和出血事件)的风险没有差异(p=0.346p=0.142p=0.633)。

每年每个中心最少要进行50例手术足以确保足够的常规手术量,从而改善院内结局,并确保了TAVI手术在全国范围内的覆盖。

原始出处:

Vera Oettinger. Outcomes of transcatheter aortic valve implantations in high-volume or low-volume centres in Germany. Heart. February 2020.

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    2020-03-06 zhaojie88
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  6. [GetPortalCommentsPageByObjectIdResponse(id=1935947, encodeId=7895193594e5f, content=<a href='/topic/show?id=6d06e826033' target=_blank style='color:#2F92EE;'>#经导管主动脉瓣植入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78260, encryptionId=6d06e826033, topicName=经导管主动脉瓣植入)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Tue Jun 30 12:50:00 CST 2020, time=2020-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1942775, encodeId=42251942e7598, content=<a href='/topic/show?id=5b6f34e758e' target=_blank style='color:#2F92EE;'>#医疗中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=34775, encryptionId=5b6f34e758e, topicName=医疗中心)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1be8234, createdName=sunyl07, createdTime=Sun Sep 06 19:50:00 CST 2020, time=2020-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332721, encodeId=fe671332e212e, 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=37, 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=Fri Mar 06 05:50:00 CST 2020, time=2020-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357425, encodeId=39e8135e4251a, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri Mar 06 05:50:00 CST 2020, time=2020-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415628, encodeId=ab43141562809, 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=35, 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=Fri Mar 06 05:50:00 CST 2020, time=2020-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510285, encodeId=a50715102851a, 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=25, 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=Fri Mar 06 05:50:00 CST 2020, time=2020-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520659, encodeId=476115206590c, content=<a href='/topic/show?id=7a736264553' target=_blank style='color:#2F92EE;'>#植入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62645, encryptionId=7a736264553, topicName=植入)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=832411313664, createdName=jiyangfei, createdTime=Fri Mar 06 05:50:00 CST 2020, time=2020-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563250, encodeId=c57f15632506a, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Fri Mar 06 05:50:00 CST 2020, time=2020-03-06, status=1, ipAttribution=)]
    2020-03-06 lsj631
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    2020-03-06 jiyangfei
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    2020-03-06 slcumt

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