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Circ Cardiovasc Qual Outcomes:中美搭桥死亡率相似,但中国平均住院20天,美国仅7天

2017-06-19 卢芳 中国循环杂志

近日,阜外医院郑哲和胡盛寿院士团队进行的研究显示,中美搭桥患者住院死亡率相似,但住院时间较长。

近日,阜外医院郑哲和胡盛寿院士团队进行的研究显示,中美搭桥患者住院死亡率相似,但住院时间较长。

该研究对中国心血管外科注册登记和全美303个医疗中心的数据进行了比较,共5.1万例患者。中国患者3.2万例,来自全国77家医院,多数为大医院和教学医院,每年搭桥100例以上。

总体而言,中国和美国搭桥手术后住院死亡率相似。对于65岁以下的患者,中美死亡率都是1%。

但对于≥65岁的老年患者,在2010年之前,中国患者住院死亡率为3.1%,高于美国的2.2%。在校正混淆因素后,依然较高。而在2011年之后,这差异消失,中国为1.23%,美国1.33%。



图1 2007-2013年中美搭桥住院死亡率变化(菱形所示为中国,圆圈为美国)

此外,研究还显示,中国搭桥手术患者的住院时间较长。中国平均总住院时间为20天,美国仅7天。中国术前住9天,美国住1天;术后中国再住9天,美国为6天。

研究还发现,中国患者平均年龄要比美国患者小3岁,伴急性心梗和心衰史者比例高,美国患者合并血脂异常、房颤糖尿病高血压、外周动脉疾病、肾衰的比例较高等。

作者介绍,我国搭桥手术医疗质量的提升有多种原因,比如开展中国心血管外科注册登记,国家医保覆盖和医疗投入增加,国内外学术交流的加强等。

但我国尚需探索适合国情的搭桥术后护理和康复的优化模式,如疗养院、心脏康复等均有助于缩短住院时间,也需优化临床途径,以合理加速患者流动,减少术后住院时间等。

原始出处:

Zhe Zheng, Heng Zhang, et al. Comparing Outcomes of Coronary Artery Bypass Grafting Among Large Teaching and Urban Hospitals in China and the United States. Circulation: Cardiovascular Quality and Outcomes. 2017;10:e003327

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    2018-01-19 quxin068
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    2017-06-21 仁者大医
  4. [GetPortalCommentsPageByObjectIdResponse(id=1938720, encodeId=07da1938e2029, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Fri Jan 19 04:58:00 CST 2018, time=2018-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663903, encodeId=0dfd16639034e, content=<a href='/topic/show?id=03a35691e2e' target=_blank style='color:#2F92EE;'>#搭桥#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56917, encryptionId=03a35691e2e, topicName=搭桥)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=557f25711234, createdName=12498b3em16(暂无昵称), createdTime=Thu Jan 11 04:58:00 CST 2018, time=2018-01-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1590781, encodeId=46441590e81a1, content=<a href='/topic/show?id=0c0b115e4cf' target=_blank style='color:#2F92EE;'>#MES#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11574, encryptionId=0c0b115e4cf, topicName=MES)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Jun 21 03:58:00 CST 2017, time=2017-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212836, encodeId=b16621283613, content=有搭桥指征愿意选择搭桥的患者确实是少数…毕竟创伤太大,人工桥血管的开发还有是广阔空间的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=4aca1635970, createdName=一露鹤笙, createdTime=Mon Jun 19 20:02:57 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212731, encodeId=42b6212e31e1, content=不错的,学习了!谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdqKgfW3nMpOkC3jXxiaW2po0PtglY5ZuVjERqKADW4HyMI8bcZXWlKgH7tEP9ULBoBzuQMibia4pr1s9rQPqLvqQJ/0, createdBy=e8c02060444, createdName=中医痴, createdTime=Mon Jun 19 13:06:43 CST 2017, time=2017-06-19, status=1, ipAttribution=)]
    2017-06-19 一露鹤笙

    有搭桥指征愿意选择搭桥的患者确实是少数…毕竟创伤太大,人工桥血管的开发还有是广阔空间的。

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1938720, encodeId=07da1938e2029, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Fri Jan 19 04:58:00 CST 2018, time=2018-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663903, encodeId=0dfd16639034e, content=<a href='/topic/show?id=03a35691e2e' target=_blank style='color:#2F92EE;'>#搭桥#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56917, encryptionId=03a35691e2e, topicName=搭桥)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=557f25711234, createdName=12498b3em16(暂无昵称), createdTime=Thu Jan 11 04:58:00 CST 2018, time=2018-01-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1590781, encodeId=46441590e81a1, content=<a href='/topic/show?id=0c0b115e4cf' target=_blank style='color:#2F92EE;'>#MES#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11574, encryptionId=0c0b115e4cf, topicName=MES)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Jun 21 03:58:00 CST 2017, time=2017-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212836, encodeId=b16621283613, content=有搭桥指征愿意选择搭桥的患者确实是少数…毕竟创伤太大,人工桥血管的开发还有是广阔空间的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=4aca1635970, createdName=一露鹤笙, createdTime=Mon Jun 19 20:02:57 CST 2017, time=2017-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212731, encodeId=42b6212e31e1, content=不错的,学习了!谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdqKgfW3nMpOkC3jXxiaW2po0PtglY5ZuVjERqKADW4HyMI8bcZXWlKgH7tEP9ULBoBzuQMibia4pr1s9rQPqLvqQJ/0, createdBy=e8c02060444, createdName=中医痴, createdTime=Mon Jun 19 13:06:43 CST 2017, time=2017-06-19, status=1, ipAttribution=)]
    2017-06-19 中医痴

    不错的,学习了!谢谢分享!

    0

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