Osmanska Joanna, Murdoch David
Clinical Research Fellow BHF GCRC, Institute of Cardiovascular and Medical Sciences, 126 University Place, University of Glasgow, Glasgow, G12 8TA.
Consultant Cardiologist Department of Cardiology, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow, G51 4TF.
Br J Cardiol. 2021 Sep 1;28(3):37. doi: 10.5837/bjc.2021.037. eCollection 2021.
Transcatheter aortic valve implantation (TAVI) is a routine procedure for patients with symptomatic severe aortic stenosis who are deemed inoperable or high-risk surgical candidates. The aim of this study was to examine real-world data on death and readmission rates in patients following the procedure. Electronic health records for patients who underwent TAVI between April 2015 and November 2018 were reviewed. Details of the procedure, complications, length of initial hospital stay and outcomes of interest (subsequent admissions and mortality) were recorded. In our cohort of 124 patients, the mean age was 80.8 years and 43% were male. Cardiac comorbidities were common, more than 30% had myocardial infarction (MI) and 15% had a previous coronary artery bypass graft (CABG). One in five suffered from chronic obstructive pulmonary disease (COPD), with similar prevalence of diabetes mellitus and cerebrovascular accident (CVA). In-hospital mortality was low at 3.3%, however, 30-day readmission rates were high at 14.6%; 44.4% were readmitted to hospital within one year. TAVI is a successful procedure in Scotland with good outcome data. The potential benefit of the procedure in many patients is limited by comorbidities, which shorten life-expectancy and lead to hospital readmission. These data highlight the importance of effective multi-disciplinary discussion in a time of realistic medicine.
经导管主动脉瓣植入术（TAVI）是针对有症状的严重主动脉瓣狭窄且被认为无法进行手术或手术风险高的患者的常规手术。本研究的目的是检查该手术后患者死亡和再入院率的真实世界数据。回顾了2015年4月至2018年11月期间接受TAVI的患者的电子健康记录。记录了手术细节、并发症、首次住院时间以及感兴趣的结果（随后的入院情况和死亡率）。在我们的124名患者队列中，平均年龄为80.8岁，43%为男性。心脏合并症很常见，超过30%有心肌梗死（MI），15%曾接受冠状动脉旁路移植术（CABG）。五分之一的患者患有慢性阻塞性肺疾病（COPD），糖尿病和脑血管意外（CVA）的患病率相似。住院死亡率较低，为3.3%，然而，30天再入院率较高，为14.6%；44.4%的患者在一年内再次入院。在苏格兰，TAVI是一种成功的手术，有良好的结果数据。该手术对许多患者的潜在益处受到合并症的限制，合并症会缩短预期寿命并导致再次入院。这些数据凸显了在现实医学时代进行有效多学科讨论的重要性。
