JAHA:在TAVR和非TAVR中心接受外科主动脉瓣置换术的住院结局差异

2019-11-29 xiangting MedSci原创

与非TAVR中心相比,在TAVR中心接受SAVR的患者生存率更高并且出院状态更好。

经导管主动脉瓣置换术TAVR)巩固了心脏团队的重要性,并彻底改变了患者对外科主动脉瓣置换术(SAVR)的选择。医院提供TAVR的能力是否会影响SAVR的结局尚不清楚。这项研究调查了TAVR与非TAVR中心SAVR后的结局。

纳入国家再入院数据库(NRD20121月至20159月接受择期SAVR≥50岁住院患者。使用多因素logistic、线性和广义logistic回归模型调整患者和医院的特征,并估算与非TAVR中心相比,在TAVR中心进行SAVR的关联。还评估了TAVR数量与结局之间的关联。

确定了SAVR住院(n=32198);22066例(69%)在TAVR中心,10132例(31%)在非TAVR中心。与非TAVR中心相比,TAVR中心的SAVRs住院死亡率(比值比0.6795CI 0.550.82)和出院到专业护理机构的几率较低(比值比0.9295CI 0.85–0.99)。LOS(估算值为-0.0995CI 0.260.08)或30天再入院率没有差异(比值比0.9595CI 0.88–1.03)。与非TAVR中心相比,在TAVR手术量最高的中心进行SAVRs的住院死亡率最低(比值比0.4395CI 0.29–0.63)。

与非TAVR中心相比,在TAVR中心接受SAVR的患者生存率更高并且出院状态更好。这代表了心脏团队治疗的益处还是当不能进行TAVRSAVR的患者选择差异,尚需要进一步研究。

原始出处:

Godly Jack. Differences in Inpatient Outcomes After Surgical Aortic Valve Replacement at Transcatheter Aortic Valve Replacement (TAVR) and Non‐TAVR Centers. JAHA. 13 Nov 2019.

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    2021-03-23 病毒猎手
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target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, 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=Sun Dec 01 09:05:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367192, encodeId=4d4a136e1923b, content=<a href='/topic/show?id=b6222320322' target=_blank style='color:#2F92EE;'>#主动脉瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23203, encryptionId=b6222320322, topicName=主动脉瓣置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b24249, createdName=medsci246, createdTime=Sun Dec 01 09:05:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415582, encodeId=be7714155825c, 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=21, 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=Sun Dec 01 09:05:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576742, encodeId=0bd815e674228, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=054816326830, createdName=ms117281293605716, createdTime=Sun Dec 01 09:05:00 CST 2019, time=2019-12-01, status=1, ipAttribution=)]
    2020-06-24 yxch48
  5. 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createdBy=054816326830, createdName=ms117281293605716, createdTime=Sun Dec 01 09:05:00 CST 2019, time=2019-12-01, status=1, ipAttribution=)]
    2019-12-01 zhaohui6731
  6. 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  7. 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  8. 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