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急性肺栓塞患者中先进治疗方法利用的时间趋势:来自国家数据库的见解。

Temporal trends in the utilization of advanced therapies among patients with acute pulmonary embolism: insights from a national database.

机构信息

Division of Cardiovascular Medicine, Boston Medical Center, 11234 Anderson St, Loma Linda, CA 92354, USA.

Boston University School of Medicine, 233 Bay State Road, Boston, MA 02215, USA.

出版信息

Eur Heart J Acute Cardiovasc Care. 2023 Oct 25;12(10):711-713. doi: 10.1093/ehjacc/zuad092.

Abstract

There is a paucity of data regarding the contemporary temporal trends in the adoption of advanced pulmonary embolism (PE) therapies in the United States as well as the parallel trends in outcomes of patients with acute PE. Therefore, we queried the Nationwide Readmissions Database (years 2016-2020) to report the temporal trends in utilization of advanced PE therapies. Our final analysis included 920 770 hospitalizations with acute PE. We demonstrated an increase in the proportion of patients diagnosed with high-risk PE during the study years. Overall, there was an increase in the use of advanced PE therapies, which was mainly due to the increase in the utilization of systemic thrombolytics, and catheter-directed therapies. Also, extracorporeal membrane oxygenation cannulation showed an incremental increase over the study years. The use of inferior vena cava filter has declined, while the use of surgical embolectomy did not change during the study years. The use of advanced therapies has increased among urban teaching, but not among urban non-teaching hospitals. During the study years, there was no change in unadjusted or adjusted in-hospital mortality rates among patients with acute PE, while the 90-day unplanned readmission rate has declined.

摘要

关于美国当代采用先进肺栓塞 (PE) 治疗方法的时间趋势以及急性 PE 患者结局的平行趋势,数据匮乏。因此,我们查询了全国再入院数据库(2016-2020 年),以报告急性 PE 先进治疗方法的时间趋势。我们的最终分析包括 920770 例急性 PE 住院患者。我们发现,在研究期间,被诊断为高危 PE 的患者比例有所增加。总体而言,先进的 PE 治疗方法的使用有所增加,这主要是由于全身溶栓和导管定向治疗的使用增加。此外,体外膜氧合插管在研究期间呈递增趋势。下腔静脉滤器的使用有所减少,而手术取栓术在研究期间没有变化。在城市教学医院中,先进治疗方法的使用有所增加,但在城市非教学医院中没有变化。在研究期间,急性 PE 患者的未调整或调整后院内死亡率没有变化,而 90 天非计划性再入院率有所下降。

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