Vervoort Dominique, Babar Maryam Salma, Sabatino Marlena E, Riaz Mehr Muhammad Adeel, Hey Matthew T, Prakash Meghana P H, Mathari Sulayman El, Kpodonu Jacques
Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St, Toronto, ON, ON M5T 3M6, Canada.
Division of Cardiac Surgery, University of Toronto, Toronto, ON, Canada.
World J Surg. 2023 Nov;47(11):2909-2916. doi: 10.1007/s00268-023-07130-1. Epub 2023 Aug 3.
Global data on cardiac surgery centers are outdated and survey-based. In 1995, there were 0.7 centers per million population, ranging from one per 120,000 in North America to one per 33 million in sub-Saharan Africa. This study analyzes the contemporary distribution of cardiac surgery centers and proposes targets relative to countries' cardiovascular disease (CVD) burdens.
Medical databases, gray literature, and governmental reports were used to identify the most recent post-2010 data that describe the number of centers performing cardiac surgery in each nation. The 2019 Institute for Health Metrics and Evaluation Global Burden of Disease Results Tool provided national CVD burdens. One-third of the CVD burden was assumed to be surgical. Center targets were proposed as the average or half of the average of centers per million surgical CVD patients in high-income countries.
5,111 cardiac surgery centers were identified across 230 nations and territories with available data, equaling 0.73 centers per million population. The median (interquartile range) number of centers ranged from 0 (0-0.06) per million in low-income countries to 0.75 (0-1.44) in high-income countries. Targets were 612.2 (optimistic) or 306.1 (conservative) centers per million surgical CVD incidence. In 2019, low-income, lower-middle-income, and upper-middle-income countries possessed 34.8, 149.0, and 271.9 centers per million surgical CVD incidence.
Little progress has been made to increase cardiac surgery centers per population despite growing CVD burdens. Today's global cardiac surgical capacity remains insufficient, disproportionately affecting the world's poorest regions.
关于心脏外科中心的全球数据已过时且基于调查。1995年，每百万人口中有0.7个中心，范围从北美每12万人有一个中心到撒哈拉以南非洲每3300万人有一个中心。本研究分析了心脏外科中心的当代分布情况，并提出了与各国心血管疾病（CVD）负担相关的目标。
利用医学数据库、灰色文献和政府报告来确定2010年后描述每个国家进行心脏手术中心数量的最新数据。2019年健康指标与评估研究所全球疾病负担结果工具提供了各国的心血管疾病负担数据。假定三分之一的心血管疾病负担需要手术治疗。中心目标设定为高收入国家每百万接受手术治疗的心血管疾病患者的中心平均数或平均数的一半。
在有可用数据的230个国家和地区共确定了5111个心脏外科中心，相当于每百万人口有0.73个中心。中心数量的中位数（四分位间距）从低收入国家每百万人口0个（0 - 0.06）到高收入国家每百万人口0.75个（0 - 1.44）不等。目标是每百万手术治疗的心血管疾病发病率有612.2个（乐观）或306.1个（保守）中心。2019年，低收入、中低收入和中高收入国家每百万手术治疗的心血管疾病发病率分别有34.8个、149.0个和271.9个中心。
尽管心血管疾病负担不断增加，但在增加人均心脏外科中心数量方面进展甚微。如今全球心脏外科手术能力仍然不足，对世界上最贫困地区的影响尤为严重。
