Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia, USA.
Department of Internal medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Catheter Cardiovasc Interv. 2021 Apr 1;97(5):E627-E635. doi: 10.1002/ccd.29222. Epub 2020 Oct 15.
There is paucity of data focusing on females' outcomes after the use of impeller pumps percutaneous ventricular assist devices (IPVADs).
Patients who received IPVADs during the period of October 1st, 2015-December 31, 2017, were identified from the United States National Readmission Database. A 1:1 propensity score matching was used to compare the outcomes between females and males.
A total of 19,278 (Female = 5,456; Male = 13,822) patients were included in the current analysis. After propensity score matching and among all-comers who were treated with IPVADs, females had higher in-hospital major adverse events (MAEs) (38 vs. 32.6%, p < .01), mortality (31 vs. 28%, p < .01), vascular complications (3.3 vs. 2.1%, p < .01), major bleeding (7.8 vs. 4.8%, p < .01), nonhome discharges (21.6 vs. 16.3%; p < .01), and longer length of stay (7 days [IQR 2-12] vs. 6 days [IQR 2-12], p = .02) with higher 30-day readmission rate compared to males (20.5 vs.16.4%, p < .01). Furthermore, among patients who received the IPVADs for high-risk percutaneous coronary intervention (HRPCI), females continued to have worse MAEs, which was driven by high rates of major bleeding. However, among patients who received IPVADs for cardiogenic shock (CS) the outcomes of females and males were comparable.
Among all-comers who received IPVADs, females suffered higher morbidity and mortality compared to males. Higher morbidity driven mainly by higher rates of major bleeding was seen among females who received IPVADs for the hemodynamic support during HRPCI and comparable outcomes were observed when the IPVADs were used for CS.
目前针对女性使用叶轮泵经皮心室辅助装置（IPVAD）后的结果数据十分有限。
从美国国家再入院数据库中确定了 2015 年 10 月 1 日至 2017 年 12 月 31 日期间接受 IPVAD 的患者。使用 1:1 倾向评分匹配来比较女性和男性患者的结果。
共纳入 19278 例（女性=5456 例；男性=13822 例）患者。经过倾向评分匹配和所有接受 IPVAD 治疗的患者中，女性的院内主要不良事件（MAE）发生率更高（38%比 32.6%，p<0.01）、死亡率更高（31%比 28%，p<0.01）、血管并发症更多（3.3%比 2.1%，p<0.01）、大出血更多（7.8%比 4.8%，p<0.01）、非出院率更高（21.6%比 16.3%，p<0.01）、住院时间更长（7 天[IQR 2-12]比 6 天[IQR 2-12]，p=0.02），30 天再入院率也高于男性（20.5%比 16.4%，p<0.01）。此外，在接受 IPVAD 治疗高危经皮冠状动脉介入（HRPCI）的患者中，女性的 MAE 持续较差，这主要是由于大出血发生率较高所致。然而，在接受 IPVAD 治疗心源性休克（CS）的患者中，女性和男性的结果相当。
在接受 IPVAD 治疗的所有患者中，女性的发病率和死亡率均高于男性。在接受 IPVAD 治疗 HRPCI 期间进行血液动力学支持的女性中，较高的发病率主要是由较高的大出血率驱动，而在接受 IPVAD 治疗 CS 的女性中则观察到相似的结果。
