Watanabe Mika, Yoneyama Kihei, Nakai Michikazu, Kanaoka Koshiro, Okayama Satoshi, Nishimura Kunihiro, Miyamoto Yoshihiro, Izumo Masaki, Ishibashi Yuki, Higuma Takumi, Harada Tomoo, Yasuda Satoshi, Murohara Toyoaki, Saito Yoshihiko, Akashi Yoshihiro J
Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine Kawasaki Japan.
National Cerebral and Cardiovascular Center Suita Japan.
Circ Rep. 2019 Dec 13;2(1):44-50. doi: 10.1253/circrep.CR-19-0065.
This study examined the influence of board-certified cardiologist characteristics on the in-hospital mortality of patients with cardiovascular disease. Data were collected between 2012 and 2014 from a nationwide database of acute care hospitals in Japan. Overall, there were 1,422,703 patients, of whom 883,746 were analyzed. The primary outcome was all-cause in-hospital mortality. The association between board-certified cardiologist characteristics and in-hospital mortality was estimated using multilevel mixed-effect logistic regression modeling. Median age of cardiologists in a hospital was not related to in-hospital mortality (OR, 1.003; 95% CI: 0.998-1.008, P=0.316), but a greater cardiologist age range was associated with a lower risk of in-hospital mortality (OR, 0.992; 95% CI: 0.988-0.995 per 1-unit increment in age range, P<0.001). Meanwhile, the average years of experience of the board-certified cardiologists in a hospital was not associated with a lower risk of in-hospital mortality (OR, 1.002; 95% CI: 0.996-1.007, P=0.525), but a greater range of years of experience was (OR, 0.986; 95% CI: 0.983-0.990 per 1-unit increment in range of years of experience, P<0.001). Median board-certified cardiologist age/experience at an institution is not related to in-hospital mortality, but a greater range in age/experience is associated with a lower risk of mortality.
本研究考察了获得委员会认证的心脏病专家的特征对心血管疾病患者院内死亡率的影响。2012年至2014年期间，研究人员从日本全国急性护理医院数据库中收集了相关数据。总体而言，共有1,422,703名患者，其中883,746名患者接受了分析。主要结局为全因院内死亡率。采用多水平混合效应逻辑回归模型评估获得委员会认证的心脏病专家的特征与院内死亡率之间的关联。医院中心脏病专家的年龄中位数与院内死亡率无关（比值比，1.003；95%置信区间：0.998 - 1.008，P = 0.316），但心脏病专家年龄范围越大，院内死亡风险越低（比值比，0.992；年龄范围每增加1个单位，95%置信区间：0.988 - 0.995，P < 0.001）。同时，医院中获得委员会认证的心脏病专家的平均经验年限与较低的院内死亡风险无关（比值比，1.002；95%置信区间：0.996 - 1.007，P = 0.525），但经验年限范围越大，死亡风险越低（比值比，0.986；经验年限范围每增加1个单位，95%置信区间：0.983 - 0.990，P < 0.001）。机构中获得委员会认证的心脏病专家的年龄/经验中位数与院内死亡率无关，但年龄/经验范围越大，死亡风险越低。
