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Circ: Cardiovasc Inte:心梗并发心源性休克短期机械循环支持使用率的医院差异

2019-01-20 xiangting MedSci原创

MI伴CS使用MCS治疗的医院间差异很大,这无法由患者特征解释。

目前关于心肌梗塞(MI)并发心源性休克(CS)短期、非耐久性机械循环支持(MCS)使用率的院间差异知之甚少。

纳入全国代表性全自费数据库2014年因MI伴CS的所有住院治疗。 评估了MI伴CS住院使用MCS的比例(MCS比率)和住院死亡率。比较MCS使用率不同四分位的医院特征和结局。在评估的1813家医院中,1440家(79.4%)每年进行≥10例经皮冠脉介入治疗。其中,1064家(73.9%)至少有1个MCS代码。41%的医院没有使用MCS。 MI伴CS住院使用MCS比例的中位数(四分位范围)为33.3%(0.0%-50.0%)。MCS使用率高的医院规模较大(P<0.001)。85%的MCS(2808/3301)是主动脉内球囊反搏。不同医院接受MCS的差异很大(2家随机医院接受MCS的中位数比值:1.58; 95%CI,1.45-1.70)。 不同MCS使用率四分位的调整后院内死亡率无差异(Q4 vs Q1;优势比,0.95; 95%CI,0.77-1.16; P=0.58)。

MI伴CS使用MCS治疗的医院间差异很大,这无法由患者特征解释。 MCS的主要形式是主动脉内球囊反搏。MCS使用率较高和较低医院间的风险调整后死亡率无差异。

原始出处:

Jordan B. Strom. Hospital Variation in the Utilization of Short-Term Nondurable Mechanical Circulatory Support in Myocardial Infarction Complicated by Cardiogenic Shock. Circ: Cardiovascular Interventions. 04 January 2019.

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

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    2019-03-21 丁鹏鹏
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    2019-06-11 quxin068
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    2019-01-22 mhm295
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