Implantable cardioverter-defibrillator therapy in Australia, 2002-2015
Implantable cardioverter-defibrillator therapy in Australia, 2002-2015
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DOI：
10.5694/mja17.01183
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发表时间：
2018-08-06
影响因子：
11.4
通讯作者：
Ingles, Jodie
中科院分区：
文献类型：
--
作者：
Blanch, Bianca;Lago, Luise P.;Ingles, Jodie
目的：量化澳大利亚按年度、患者年龄和性别划分的植入式心律转复除颤器（ICD）手术的数量，并估计特定年龄组的人口比率和相关费用。设计、设置：回顾性观察性研究；分析澳大利亚国家医院发病率数据库的医院程序数据。研究对象：2002年7月至2015年6月，有ICD插入、更换、调整或取出程序代码的患者。主要观察指标：按手术年份、患者年龄（0-34岁、35-69岁、70岁及以上）和性别划分的ICD手术次数；特定年龄组人群的手术率；与并发症相关的手术数量。结果：ICD手术数从2002-03年度的1844例增加到2014-15年度的6504例；超过75%的手术是在男性身上进行的。2014- 2015年，70岁及以上人群的ICD植入率为每10万人78.1人，35-69岁人群22人，35岁以下人群1.40人。报告的并发症发生率从2002-03年的45%下降到2014-15年的19%，部分原因是并发症编码发生了变化。每年移除的次数至少相当于插入次数的4%。2011- 2014年期间，使用ICD程序住院的总费用为445 644 566美元。结论：ICD手术在澳大利亚变得越来越频繁，特别是在70岁或以上的人群中。应调查与ICD治疗相关的护理模式，特别是与不良事件相关的患者和医院相关因素，以更好地了解和改善患者的结果。
Objectives: To quantify the number of implantable cardioverter-defibrillator (ICD) procedures in Australia by year, patient age and sex, and to estimate age group-specific population rates and the associated costs.Design, setting: Retrospective observational study; analysis of Australian National Hospital Morbidity Database hospital procedures data.Participants: Patients with an ICD insertion, replacement, adjustment, or removal procedure code, July 2002 - June 2015.Main outcome measures: Number of ICD procedures by procedure year, patient age (0-34, 35-69, 70 years or more) and sex; age group-specific population procedure rates; number of procedures associated with complications.Results: The number of ICD procedures increased from 1844 in 2002-03 to 6504 in 2014-15; more than 75% of procedures were in men. In 2014-15, the ICD insertion rate for people aged 70 years or more was 78.1 per 100 000 population, 22 per 100 000 for those aged 35-69 years, and 1.40 per 100 000 people under 35. The reported complication rate decreased from 45% in 2002-03 to 19% in 2014-15, party because of a change in the coding of complications. The number of removals corresponded to at least 4% of the number of insertions each year. The aggregate cost of hospitalisations with an ICD procedure during 2011-14 was $445 644 566.Conclusion: ICD procedures are becoming more frequent in Australia, particularly in people aged 70 or more. Patterns of care associated with ICD therapy, particularly patient- and hospital-related factors associated with adverse events, should be investigated to better understand and improve patient outcomes.