婆罗门
精华
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战斗力 鹅
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回帖 0
注册时间 2004-6-9
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https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.119.044007
2019年的报告,在统计上就显示出Impella更糟糕了
Among patients undergoing PCI treated with MCS, 4782 (9.9%) received Impella; its use increased over time, reaching 31.9% of MCS in 2016. There was wide variation in Impella use across hospitals (>5-fold variation). Specifically, among patients receiving Impella, there was a wide variation in outcomes of bleeding (>2.5-fold variation), and death, acute kidney injury, and stroke (all ≈1.5-fold variation). Adverse outcomes and costs were higher in the Impella era (years 2008–2016) versus the pre-Impella era (years 2004–2007). Hospitals with higher Impella use had higher rates of adverse outcomes and costs. After adjustment for the propensity score, and accounting for clustering of patients by hospitals, Impella use was associated with death: odds ratio, 1.24 (95% CI, 1.13–1.36); bleeding: odds ratio, 1.10 (95% CI, 1.00–1.21); and stroke: odds ratio, 1.34 (95% CI, 1.18–1.53), although a similar, nonsignificant result was observed for acute kidney injury: odds ratio, 1.08 (95% CI, 1.00–1.17). 在接受 MCS 治疗的 PCI 患者中,有 4782 人(9.9%)接受了 Impella 治疗;随着时间的推移,Impella 的使用率不断上升,2016 年达到了 MCS 的 31.9%。Impella在不同医院的使用率差异很大(>5倍)。具体而言,在接受Impella治疗的患者中,出血(差异>2.5倍)、死亡、急性肾损伤和中风(差异均≈1.5倍)等结果差异很大。Impella时代(2008-2016年)的不良后果和成本高于Impella时代之前(2004-2007年)。Impella使用率较高的医院不良后果发生率和成本较高。在对倾向评分进行调整并考虑到医院对患者的聚类后,Impella 的使用与死亡相关:几率比为 1.24(95% CI,1.13-1.36);出血:几率比为 1.10(95% CI,1.00-1.21);中风:几率比为 1.34(95% CI,1.18-1.53),但急性肾损伤:几率比为 1.08(95% CI,1.00-1.17),也出现了类似的非显著性结果。
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