中国高容量心脏中心与胸外科医师协会(STS)数据中瓣膜性心脏病外科治疗的比较研究

A Comparative Study on Surgical Treatment of Valvular Heart Disease between High-Volume Cardiac Centers in China and STS Data.

作者信息

Lin Hongyuan, Gong Jiamiao, Wu Yongjian, Zheng Zhe, Hou Jianfeng

机构信息

Cardiac Surgery Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.

出版信息

J Cardiovasc Dev Dis. 2022 Jul 2;9(7):212. doi: 10.3390/jcdd9070212.

Abstract

The goal of this study is to summarize valvular surgery data from the Chinese Cardiac Surgery Registry (CCSR) and compare it to the most recent data from the Society of Thoracic Surgeons (STS). From 2016 to 2018, a total of 34,386 cases of the seven most common valvular surgical procedures was obtained from the CCSR. We calculated the proportions of different procedures in the CCSR cohort (n = 34,386) as well as the change in operation volume for each procedure. We also compiled rates of postoperative in-hospital mortality and five major complications across all procedures. All of the results were compared to the STS data. The CCSR and STS data showed divergent trends in valvular heart disease features and operation volume. Although the proportion of MV repair in the CCSR (13.7%) data was lower than in the STS data (23.2%), it demonstrated a substantial upward trend. In terms of operation volume, the CCSR data showed an upward trend, but the STS data showed a downward trend. CCSR procedures showed lower mortality (2% vs. 2.6%), reoperation (2.8% vs. 4.3%), and permanent stroke (0.5% vs. 1.6%) rates than STS procedures but higher rates of prolonged ventilation (22.4% vs. 10.4%) and renal failure (5.6% vs. 3.2%). Valvular surgery quality in China's leading cardiac hospitals is roughly comparable to that in the United States. China, on the other hand, has some shortcomings that need improvement.

摘要

本研究的目的是总结中国心脏手术注册系统(CCSR)中的瓣膜手术数据,并将其与胸外科医师协会(STS)的最新数据进行比较。2016年至2018年,共从CCSR中获取了34386例七种最常见的瓣膜手术病例。我们计算了CCSR队列(n = 34386)中不同手术的比例以及每种手术的手术量变化。我们还汇总了所有手术的术后住院死亡率和五种主要并发症的发生率。所有结果均与STS数据进行了比较。CCSR和STS数据在瓣膜性心脏病特征和手术量方面呈现出不同的趋势。尽管CCSR数据中二尖瓣修复的比例(13.7%)低于STS数据(23.2%),但显示出大幅上升趋势。在手术量方面,CCSR数据呈上升趋势,而STS数据呈下降趋势。CCSR手术的死亡率(2%对2.6%)、再次手术率(2.8%对4.3%)和永久性卒中率(0.5%对1.6%)低于STS手术,但延长通气率(22.4%对10.4%)和肾衰竭率(5.6%对3.2%)较高。中国主要心脏医院的瓣膜手术质量与美国大致相当。另一方面,中国也存在一些需要改进的不足之处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0b3/9319982/d74a1af18230/jcdd-09-00212-g001.jpg

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