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深静脉血栓形成的机械血栓切除术的结果:来自PINC AI医疗数据库的见解。

Outcomes From Mechanical Thrombectomy for Deep Vein Thrombosis: Insights From the PINC AI Healthcare Database.

作者信息

Mittleider Derek, Gibson C Michael, Dexter David

机构信息

Brevard Physician Associates, Melbourne, Florida.

Boston Clinical Research Institute, Newton, Massachusetts.

出版信息

J Soc Cardiovasc Angiogr Interv. 2024 Jul 25;3(8):102149. doi: 10.1016/j.jscai.2024.102149. eCollection 2024 Aug.

Abstract

BACKGROUND

Mechanical thrombectomy (MT) is playing an increasingly important role in treating deep vein thrombosis (DVT). Although degrees of safety and efficacy have been shown in independent studies, there remains a lack of comparative evidence between MT devices. To address this, we aimed to compare demographics, clinical outcomes, and resource metrics of patients receiving MT for DVT with 3 common devices using a real-world database.

METHODS

Patients receiving MT for DVT between January 2018 and March 2022 were identified from the PINC AI Healthcare Database and divided into analysis populations for the AngioJet ZelanteDVT (AJ), the ClotTriever system (CT), and the Indigo system (IN). Rates of in-hospital mortality, resource utilization, and 30-day readmission were compared. Regression modeling was performed to adjust for potential covariates and compare outcomes.

RESULTS

A total of 4455 MT encounters were identified and met inclusion criteria (AJ, 1753; CT, 1344; IN, 1358). In-hospital mortality ranged from 1.0% (CT) to 2.9% (IN), with modeling predicting significantly higher odds for the AJ (odds ratio [OR], 3.42) and IN (OR, 3.38) groups. Similarly, higher rates of resource utilization were predicted in the AJ and IN groups when compared with the reference group (CT). Average costs ranged from $29,549 (CT: SD, $30,705) to $42,705 (IN: SD, $41,114). Thirty-day readmissions ranged from 10.0% (AJ) to 14.6% (IN), while modeling predicted significantly greater odds for the IN group (OR, 1.47).

CONCLUSIONS

These results suggest that all MT interventions may be unequal in terms of outcomes and resources, with the CT device associated with lower in-hospital mortality and resource burden.

摘要

背景

机械血栓切除术(MT)在治疗深静脉血栓形成(DVT)中发挥着越来越重要的作用。尽管在独立研究中已显示出一定程度的安全性和有效性,但MT设备之间仍缺乏比较证据。为解决这一问题,我们旨在使用真实世界数据库比较接受MT治疗DVT的患者的人口统计学、临床结局和资源指标,涉及3种常用设备。

方法

从PINC AI医疗保健数据库中识别出2018年1月至2022年3月期间接受MT治疗DVT的患者,并分为AngioJet ZelanteDVT(AJ)、ClotTriever系统(CT)和Indigo系统(IN)的分析人群。比较住院死亡率、资源利用率和30天再入院率。进行回归建模以调整潜在的协变量并比较结局。

结果

共识别出4455次MT治疗病例并符合纳入标准(AJ组1753例;CT组1344例;IN组1358例)。住院死亡率从1.0%(CT组)到2.9%(IN组)不等,建模预测AJ组(优势比[OR],3.42)和IN组(OR,3.38)的死亡几率显著更高。同样,与参照组(CT组)相比,AJ组和IN组的资源利用率预测值更高。平均费用从29,549美元(CT组:标准差,30,705美元)到42,705美元(IN组:标准差,41,114美元)不等。30天再入院率从10.0%(AJ组)到14.6%(IN组)不等,而建模预测IN组的再入院几率显著更高(OR,1.47)。

结论

这些结果表明,所有MT干预措施在结局和资源方面可能并不相同,CT设备与较低的住院死亡率和资源负担相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/095a/11330914/7e30d58f45d7/gr1.jpg

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