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澳大利亚经皮冠状动脉介入治疗后非计划心脏再入院与性别的关联:多中心结局登记研究(创世纪医疗心血管结局登记研究)的结果

The Association of Sex with Unplanned Cardiac Readmissions following Percutaneous Coronary Intervention in Australia: Results from a Multicentre Outcomes Registry (GenesisCare Cardiovascular Outcomes Registry).

作者信息

Conradie Andre, Atherton John, Chowdhury Enayet, Duong MyNgan, Schwarz Nisha, Worthley Stephen, Eccleston David

机构信息

Friendly Society Private Hospital, Bundaberg, QLD 4670, Australia.

Royal Brisbane and Women's Hospital, Brisbane, QLD 4029, Australia.

出版信息

J Clin Med. 2022 Nov 21;11(22):6866. doi: 10.3390/jcm11226866.

Abstract

Background and aim: Unplanned cardiac readmissions in patients with percutaneous intervention (PCI) is very common and is seen as a quality indicator of in-hospital care. Most studies have reported on the 30-day cardiac readmission rates, with very limited information being available on 1-year readmission rates and their association with mortality. The aim of this study was to investigate the impact of biological sex at 1-year post-PCI on unplanned cardiac readmissions. Methods and results: Patients enrolled into the GenesisCare Cardiovascular Outcomes Registry (GCOR-PCI) from December 2008 to December 2020 were included in the study. A total of 13,996 patients completed 12 months of follow-up and were assessed for unplanned cardiac readmissions. All patients with unplanned cardiac readmissions in the first year of post-PCI were followed in year 2 (post-PCI) for survival status. The rate of unplanned cardiac readmissions was 10.1%. Women had a 29% higher risk of unplanned cardiac readmission (HR 1.29, 95% CI 1.11 to 1.48; p = 0.001), and female sex was identified as an independent predictor of unplanned cardiac readmissions. Any unplanned cardiac readmission in the first year was associated with a 2.5-fold higher risk of mortality (HR 2.50, 95% CI 1.67 to 3.75; p < 0.001), which was similar for men and women. Conclusion: Unplanned cardiac readmissions in the first year post-PCI was strongly associated with increased all-cause mortality. Whilst the incidence of all-cause mortality was similar between women and men, a higher incidence of unplanned cardiac readmissions was observed for women, suggesting distinct predictors of unplanned cardiac readmissions exist between women and men.

摘要

背景与目的

经皮介入治疗(PCI)患者的非计划心脏再入院情况非常常见,且被视为住院治疗质量的一个指标。大多数研究报告的是30天心脏再入院率,关于1年再入院率及其与死亡率的关联的信息非常有限。本研究的目的是调查PCI术后1年时的生物性别对非计划心脏再入院的影响。

方法与结果

纳入2008年12月至2020年12月登记到GenesisCare心血管结局注册研究(GCOR-PCI)中的患者。共有13996例患者完成了12个月的随访,并对非计划心脏再入院情况进行了评估。PCI术后第一年所有非计划心脏再入院的患者在第2年(PCI术后)随访生存状况。非计划心脏再入院率为10.1%。女性发生非计划心脏再入院的风险高29%(风险比1.29,95%置信区间1.11至1.48;p = 0.001),女性性别被确定为非计划心脏再入院的独立预测因素。第一年的任何非计划心脏再入院都与死亡风险高2.5倍相关(风险比2.50,95%置信区间1.67至3.75;p < 0.001),男性和女性情况相似。

结论

PCI术后第一年的非计划心脏再入院与全因死亡率增加密切相关。虽然男性和女性的全因死亡率发生率相似,但女性的非计划心脏再入院发生率较高,这表明男性和女性存在不同的非计划心脏再入院预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae76/9692358/167aabe71da4/jcm-11-06866-g001.jpg

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