Lage M J, Barber B L, McCollam P L, Bala M, Scherer J
Department of Economics, Miami University, Oxford, Ohio, USA.
Catheter Cardiovasc Interv. 2001 Jul;53(3):296-303. doi: 10.1002/ccd.1170.
The purpose of this study is to compare the profile of percutaneous coronary intervention (PCI) patients who receive abciximab versus eptifibatide, as well as to compare the effect of abciximab versus eptifibatide on hospital length of stay. Retrospective data were obtained from HCIA's Clinical Pathways Database on 5,446 coronary angioplasty patients who were administered either abciximab or eptifibatide. Estimation was conducted via a two-stage sample selection model. In the first stage, a probit regression was employed to determine which factors were associated with a higher probability of being administered abciximab versus eptifibatide. In the second stage, a negative binomial model was used to estimate the impact of a wide range of factors (selection of GPIIb/IIIa, patient demographics, insurance provider, health conditions, admission information, and hospital characteristics) on total hospital length of stay, as well as on postprocedural length of stay. After controlling for high-risk indications and other sources of selection bias, results indicate that receipt of abciximab was associated with a significantly shorter length of total hospital stay (0.83 fewer days; P < 0.001) than receipt of eptifibatide. Additionally, receipt of abciximab was found to be associated with a significantly shorter postprocedural hospital length of stay (0.48 fewer days; P = 0.002) compared to receipt of eptifibatide. Results of this study indicate that PCI patients who are administered abciximab versus eptifibatide have a significantly shorter length of hospital stay (both total and postprocedural). This finding is important since hospital length of stay reflects the occurrence of complications and has been found to be directly related to the resources consumed during in-patient management of patients. Cathet Cardiovasc Intervent 2001;53:296-303.
本研究的目的是比较接受阿昔单抗与依替巴肽治疗的经皮冠状动脉介入治疗(PCI)患者的情况,以及比较阿昔单抗与依替巴肽对住院时间的影响。回顾性数据来自HCIA临床路径数据库中5446例接受阿昔单抗或依替巴肽治疗的冠状动脉血管成形术患者。通过两阶段样本选择模型进行估计。在第一阶段,采用概率单位回归来确定哪些因素与接受阿昔单抗而非依替巴肽治疗的较高概率相关。在第二阶段,使用负二项模型来估计一系列因素(糖蛋白IIb/IIIa的选择、患者人口统计学特征、保险提供商、健康状况、入院信息和医院特征)对总住院时间以及术后住院时间的影响。在控制了高风险指征和其他选择偏倚来源后,结果表明,与接受依替巴肽相比,接受阿昔单抗治疗的患者总住院时间显著缩短(少0.83天;P<0.001)。此外,与接受依替巴肽相比,接受阿昔单抗治疗的患者术后住院时间也显著缩短(少0.48天;P = 0.002)。本研究结果表明,接受阿昔单抗与依替巴肽治疗的PCI患者住院时间(包括总住院时间和术后住院时间)显著缩短。这一发现很重要,因为住院时间反映了并发症的发生情况,并且已发现与患者住院管理期间消耗的资源直接相关。《心血管介入导管杂志》2001年;53:296 - 303。