Heart:美国Fontan手术的趋势和院内结局

2018-11-08 xiangting MedSci原创

美国每年进行1062例Fontan手术,手术量无变化,但15年间院内死亡率和术后并发症有所减少。

美国Fontan手术的全国普及率和结局尚不清楚。这项研究旨在确定Fontan手术年手术量、院内死亡率、术后并发症和出院类型的趋势(时间变化)。

使用国际疾病分类-第九版、Fontan手术临床修改手术代码,即35.94,对2001年至2014年进行Fontan手术的全国住院患者样本进行检索。为了评估患者人口学随时间的变化,研究人员根据手术年度(2001-2004、2005-2008、2009-2011和2012-2014)将患者群分为4组。

2001年到2014年,美国约进行了15934例Fontan手术。中位年龄(Q1-Q3)为3(2-4)岁,39.8%为女性。左心发育不良综合征是最常见的先天性心脏病诊断(29%)。2001年约进行了1175例手术,2014年为1340例,但每年的手术量没有显著变化(p=0.47)。院内死亡率从2001年的4.5%(53/1175)明显下降到2014年的1.1%(15/1340)(p=0.009)。当比较2001-2004和2012-2014期间的事件发生率时,术后心脏并发症(12.6%(459/3640)至8%(378/4706),p=0.007)和呼吸系统并发症均显著下降(17.1%(623/3640)至10.2%(481/4706),p<0.001)。然而,通过医疗援助出院回家或转到其他急症治疗机构的患者数量增多(5.8%(211/3640)至9.4%(443/4706),p=0.01),通货膨胀调整的住院费也有升高(46978美元至60383美元,p<0.001),但住院时间没有显著变化(p=0.73)。

平均来说,美国每年进行1062例Fontan手术,手术量无变化,但15年间院内死亡率和术后并发症有所减少。

原始出处:

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    2018-11-10 zhaojie88
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    2018-11-10 slcumt
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    2018-11-10 xuyu

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