Backes Carl H, Bergersen Lisa, Rome Jonathan J, Batlivala Sarosh P, Glatz Andrew C, Ovunc Bugsu, David Sthuthi, Rivera Brian K, Haque Urbee, Kollins Kevin, Yin Han, Holzer Ralf J
Nationwide Children's Hospital, Columbus, Ohio.
Catheter Cardiovasc Interv. 2015 Jan 1;85(1):104-10. doi: 10.1002/ccd.25683. Epub 2014 Oct 7.
To characterize the frequency and attributability of death among patients who died within 30 days of their cardiac catheterization (30-day mortality).
30-day postprocedure mortality is commonly used as a quality outcome metric in national cardiac catheterization registries. It is unclear if this parameter is sufficiently specific to meaningfully capture mortality attributable to cardiac catheterization in patients with congenital heart disease (CHD).
Multicenter cohort study with 3 participating centers. Records were retrospectively reviewed for patients who died within 30 days of catheterization (06/2007-06/2012). Attributability of death was assigned to each case.
A total of 14,707 cardiac catheterization procedures were performed during the study period. Death occurred within 30 days in 279/14,707 (1.9%) of cases. Among the patients who died, 53% of cases were emergent or urgent cases. The median age was 4 mos (1 day-45 years). Death was attributable to the catheterization procedure in 29/279 (10%) of cases. Death was attributable to cardiac surgery in 14%, precatheterization clinical status in 34%, postcatheterization clinical status in 22%, and noncardiac comorbidity in 19%. In 1%, death attributability could not be established.
While valuable in adult settings, 30-day mortality is inadequate as a quality metric among patients with CHD undergoing cardiac catheterization. To derive the optimal benefit from catheterization registry data, more robust methodologies to capture procedure-related mortality are needed. © 2014 Wiley Periodicals, Inc.
描述在心脏导管插入术后30天内死亡患者的死亡频率及归因（30天死亡率）。
术后30天死亡率通常作为国家心脏导管插入术登记中的一项质量结果指标。尚不清楚该参数是否足够具体，以有意义地捕捉先天性心脏病（CHD）患者中归因于心脏导管插入术的死亡率。
一项有3个参与中心的多中心队列研究。对在导管插入术后30天内死亡的患者（2007年6月至2012年6月）的记录进行回顾性审查。为每个病例确定死亡归因。
在研究期间共进行了14,707例心脏导管插入术。279/14,707例（1.9%）在30天内死亡。在死亡患者中，53%的病例为急诊或紧急病例。中位年龄为4个月（1天至45岁）。29/279例（10%）的死亡归因于导管插入术。14%的死亡归因于心脏手术，34%归因于导管插入术前的临床状况，22%归因于导管插入术后的临床状况，19%归因于非心脏合并症。1%的死亡归因无法确定。
虽然30天死亡率在成人环境中有价值，但作为接受心脏导管插入术的CHD患者的质量指标并不充分。为了从导管插入术登记数据中获得最佳益处，需要更可靠的方法来捕捉与手术相关的死亡率。©2014威利期刊公司。
