Utilization of arterial pulse waveform analysis during non-cardiac surgery in Japan: a retrospective observational study using a nationwide claims database.
Utilization of arterial pulse waveform analysis during non-cardiac surgery in Japan: a retrospective observational study using a nationwide claims database.
复制标题
日本非心脏手术期间动脉脉搏波形分析的利用：利用全国理赔数据库进行的回顾性观察研究。
DOI：
10.1007/s00540-018-02609-x
复制
发表时间：
2019
影响因子：
2.8
通讯作者：
Kawakami K
中科院分区：
文献类型：
--
作者：
Takeda C;Takeuchi M;Mizota T;Yonekura H;Nahara I;Kuwauchi A;Joo WJ;Kawasaki Y;Kawakami K
动脉脉搏波分析(APWA)用于心输出量监测。然而，关于用于APWA的专用压力传感器(S-APWA)的频率和患者特征的数据缺乏。我们回顾了2014年1月1日至2016年12月31日期间在动脉导管全身麻醉下接受非心脏手术的175,201名年龄在18岁及以上的患者。我们提取了关于患者人口统计学、合并症、手术和麻醉特征以及医院特征的数据。在完整的研究队列中，24,605名患者(14.0%)接受了S-APWA的监测。此外，接受高风险手术的患者使用S-APWA的比例高于接受低风险手术的患者[高与低：调整后的优势比(AOR)1.95；95%可信区间(CI)1.76-2.15，中与低：AOR 1.11；95%CI 1.01-1.22]以及合并更多并发症的患者(高与低：AOR 1.49；95%CI 1.42-1.56；中与低：AOR 1.25；95%CI 1.20-1.31)。S-APWA的使用与手术风险和患者的合并症显著相关。综上所述，我们的研究可能会为未来有关S-APWA的适当使用的研究提供一个基准。
Arterial pulse waveform analysis (APWA) is used for cardiac output monitoring. However, data on the frequency of and patient characteristics for specialized pressure transducer for APWA (S-APWA) use are lacking. We retrospectively identified 175,201 patients aged 18 years or older, who underwent non-cardiac surgery under general anesthesia with an arterial catheter from January 1, 2014, to December 31, 2016. We extracted data on patient demographics, comorbidities, surgical and anesthesia characteristics, and hospital characteristics. Among the full study cohort, 24,605 (14.0%) patients were monitored using S-APWA. Further, the use of S-APWA was higher in patients undergoing high-risk surgery than in those undergoing low-risk surgery [high vs low: adjusted odds ratio (aOR) 1.95; 95% confidence interval (CI) 1.76–2.15, moderate vs low: aOR 1.11; 95% CI 1.01–1.22] and those with more comorbidities than in those with less comorbidities (high vs low: aOR 1.49; 95% CI 1.42–1.56, moderate vs low: aOR 1.25; 95% CI 1.20–1.31). S-APWA use was significantly associated with both surgery risk and patients’ comorbidities. In conclusion, our study may provide a benchmark for future studies related to the appropriate use of S-APWA.