Cardiac Surgery Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, North Lishi Street, Xicheng District, , Beijing, 100037, China.
BMC Cardiovasc Disord. 2022 Apr 21;22(1):188. doi: 10.1186/s12872-022-02612-x.
To characterize surgical valvular heart diseases (VHDs) in China and disclose regional variations in VHD surgeries by analyzing the data derived from the Chinese Cardiac Surgery Registry (CCSR).
From January 2016 to December 2018, we consecutively collected the demographic information, clinical characteristics and outcomes of 38,131 adult patients undergoing valvular surgery in China. We sought to assess the quality of VHD surgery by examining in-hospital deaths of all patients from 7 geographic regions. Using a hierarchical generalized linear model, we calculated the risk-standardized mortality rate (RSMR) of each region. By comparing VHD characteristics and RSMRs, we pursued an investigation into regional variations. The mean age was 54.4 ± 12.4 years, and 47.2% of the patients were females. Among cases, the number of aortic valve surgeries was 9361 (24.5%), which was less than that of mitral valve surgeries (n = 14,506, 38.0%). The number of concurrent aortic and mitral valve surgeries was 6984 (18.3%). A total of 4529 surgical VHD patients (11.9%) also underwent coronary artery bypass grafting (CABG) surgery. The overall in-hospital mortality rate was 2.17%. The lowest RSMR, 0.91%, was found in the southwest region, and the highest RSMR, 3.99%, was found in the northeast.
Although the overall valvular surgical mortality rate in large Chinese cardiac centers was in line with high-income countries, there were marked regional variations in the characteristics and outcomes of surgical VHD patients across China.
通过分析中国心脏手术注册（CCSR）的数据，描述中国的外科心脏瓣膜病（VHD）特征，并揭示 VHD 手术的地区差异。
2016 年 1 月至 2018 年 12 月，我们连续收集了中国 38131 例成年 VHD 手术患者的人口统计学信息、临床特征和结局。我们试图通过检查来自 7 个地理区域的所有患者的住院内死亡情况来评估 VHD 手术的质量。使用分层广义线性模型，我们计算了每个地区的风险标准化死亡率（RSMR）。通过比较 VHD 特征和 RSMR，我们调查了地区差异。患者的平均年龄为 54.4±12.4 岁，其中 47.2%为女性。在这些病例中，主动脉瓣手术数量为 9361 例（24.5%），低于二尖瓣手术（n=14506 例，38.0%）。同期行主动脉瓣和二尖瓣手术的患者有 6984 例（18.3%）。共有 4529 例外科 VHD 患者（11.9%）还接受了冠状动脉旁路移植术（CABG）。总体住院死亡率为 2.17%。西南地区的 RSMR 最低，为 0.91%，东北地区的 RSMR 最高，为 3.99%。
尽管中国大型心脏中心的整体瓣膜手术死亡率与高收入国家相当，但中国外科 VHD 患者的特征和结局在各地区存在明显差异。
