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JAHA:手术和介入治疗主动脉夹层的住院率和院内死亡率

2019-04-25 xiangting MedSci原创

这是首个在全国范围内报告手术/介入治疗AD住院率和死亡率的研究。

关于主动脉夹层(ADs)患者发病率和死亡率的人群数据很少。因此,这项研究对2006年至2014年期间,在德国全国基础上因A型ADs(TAADs)和B型ADs(TBADs)接受开放性或血管内手术患者的住院率和院内死亡率进行了分析。

对手术/介入治疗的AD患者进行由德国联邦统计局编制的全国诊断相关组统计的二级数据分析(国际疾病分类,第十次修订,德国修订版[ICD-10-GM]编码I71.00-I71.07;n=20533)。通过使用特定的手术编码,区分TAAD(n=14 911/72.6%)和 TBAD(n=5622/27.4%)。手术/介入治疗AD的标准化住院率为每年2.7/10万,其中TAAD每年2.0/10万,TBAD每年0.7/10万。TAAD院内死亡率是19.5%;TBAD为9.3%。9年间住院率和院内死亡率均有所增加。血管内治疗TBAD的份额在同一时间间隔内稳步增加。多级多因素分析显示对于TAAD,年龄和合并症与死亡风险较高显著相关。TBAD也是如此。性别与死亡率无显著相关性。TAAD的年度中心手术量与死亡率之间存在显著相关性,但不是 TBAD。

这是首个在全国范围内报告手术/介入治疗AD住院率和死亡率的研究。总的来说,在德国,TAAD和TBAD的住院率和死亡率随时间增加。此外,TAAD 在大手术量中心进行更安全。

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    2019-04-27 仁心济世
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