Division of Cardiovascular Medicine, Heart & Vascular Institute, West Virginia University, Morgantown, West Virginia, USA.
Department of Medicine, West Virginia University, Morgantown, West Virginia, USA.
Catheter Cardiovasc Interv. 2021 Jan 1;97(1):E104-E112. doi: 10.1002/ccd.28913. Epub 2020 May 6.
We aimed to assess the in-hospital outcomes in patients with mitral regurgitation treated with percutaneous mitral valve repair (PMVR) among patients with chronic obstructive pulmonary disease (COPD).
There is lack of data on the outcomes of PMVR for mitral regurgitation in patients with COPD.
We analyzed the national inpatient sample (NIS) database from January 2012 to December 2016.
A total of 9125 patients underwent PMVR in the period between January 2012 and December 2016, of whom 2,495 (27.3%) patients had concomitant COPD. Comparing COPD patients to non-COPD patients, COPD patients had higher proportion of females (48.3% vs. 46.6%, p = .16), were younger (75.8 ± 10.0 years vs. 76.4 ± 12.2 years; p = .04), had higher prevalence of peripheral vascular disease (17.4% vs. 13.5%; p < .01) and renal failure (39.3% vs. 37%; p < .01). After propensity matching, there was no significant difference in mortality among the COPD group versus non-COPD patients (2.6% vs. 2.9%; p = .6). Patients with COPD had higher proportion of in-hospital morbidities including St-segment elevation myocardial infarction (1.8% vs. 1.0%; p = .02), cardiogenic shock (1.4% vs. 0.4%; p < .01), vascular complications (2% vs. 0.8; p < .01), pneumothorax (1% vs. 0.4%; p < .01), and septic shock (1.2% vs. 0.4%; p < .01). Moreover, surrogates of severe disability (mechanical intubation and non-home discharges), cost of hospitalization, and length of stay were higher in the COPD group.
There was no difference in mortality between the COPD and non-COPD patients after PMVR. Moreover, we observed higher rates of in-hospital morbidities, surrogates of severe disability, and higher resources utilization by the COPD group.
评估慢性阻塞性肺疾病（COPD）患者行经皮二尖瓣修复术（PMVR）治疗二尖瓣反流的住院期间结局。
关于 COPD 患者 PMVR 治疗二尖瓣反流的结局数据尚缺乏。
我们分析了 2012 年 1 月至 2016 年 12 月期间的国家住院患者样本（NIS）数据库。
在 2012 年 1 月至 2016 年 12 月期间，共有 9125 例患者接受了 PMVR，其中 2495 例（27.3%）患者同时患有 COPD。与非 COPD 患者相比，COPD 患者中女性比例更高（48.3% vs. 46.6%，p =.16），年龄更小（75.8 ± 10.0 岁 vs. 76.4 ± 12.2 岁；p =.04），外周血管疾病（17.4% vs. 13.5%；p < .01）和肾衰竭（39.3% vs. 37%；p < .01）的患病率更高。在倾向评分匹配后，COPD 组与非 COPD 患者的死亡率无显著差异（2.6% vs. 2.9%；p =.6）。COPD 患者住院期间发生包括 ST 段抬高型心肌梗死（1.8% vs. 1.0%；p =.02）、心源性休克（1.4% vs. 0.4%；p < .01）、血管并发症（2% vs. 0.8%；p < .01）、气胸（1% vs. 0.4%；p < .01）和感染性休克（1.2% vs. 0.4%；p < .01）等并发症的比例更高。此外，COPD 组严重残疾（机械通气和非家庭出院）、住院费用和住院时间的替代指标更高。
PMVR 后 COPD 患者与非 COPD 患者的死亡率无差异。此外，我们观察到 COPD 组的住院期间并发症发生率、严重残疾替代指标和资源利用更高。
