National trends in repair for type B aortic dissection.
National trends in repair for type B aortic dissection.
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DOI：
10.1002/clc.23672
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发表时间：
2021-08
影响因子：
2.7
通讯作者：
Jones WS
中科院分区：
文献类型：
--
作者：
Weissler EH;Osazuwa-Peters OL;Greiner MA;Hughes GC;Long CA;Vemulapalli S;Patel MR;Jones WS
胸主动脉腔内修复术（TEVAR）在21世纪初首次流行于修复B型主动脉夹层（TBAD）。我们的目的是描述接受开放修复、TEVAR和未修复的患者，并分析当代14天内与修复相关的因素。我们使用MarketScan数据库查找2014年至2017年期间的TBAD患者。为了评估与早期修复相关的因素，使用了单变量和多变量对数二项回归。2014年至2017年，美国共有2613例TBAD患者入院，其中38.4%在入院后14天内接受了修复术（25.3%开放修复术和13.1% TEVAR）。在研究期间，14天内修复的发生率下降（2014年研究队列的43%降至2017年的26.4%），主要是由于开放性修复从2014年的30.8%降至2017年的12.5%。在多变量分析中，年龄较大、大西洋中部地区、糖尿病、胰岛素使用、抗血小板药物使用和最近的年份与早期修复的可能性较低相关;男性、外周血管疾病、肢体缺血、破裂、休克和酸中毒与修复的可能性较高相关。总体而言，从2014年到2017年，14天内TBAD修复率下降，TEVAR率稳定，但开放修复率下降。需要进一步调查与修复可能性相关的供应商和医院特定因素。
Thoracic endovascular aortic repair (TEVAR) first gained in popularity for repair of type B aortic dissections (TBADs) in the early 2000's. We aimed to describe patients undergoing open repair, TEVAR, and no repair and analyze factors associated with repair within 14 days of presentation in the contemporary era. We used the MarketScan database to find patients with TBAD between 2014 and 2017. To assess factors associated with early repair, univariable, and multivariable log‐binomial regression were used. There were 2613 patients admitted with TBAD between 2014 and 2017 across the United States, of whom 38.4% underwent repair within 14 days of admission (25.3% open repair and 13.1% TEVAR). The incidence of repair within 14 days decreased over the study period (43% of the study cohort in 2014 to 26.4% in 2017) primarily due to a decrease in open repairs from 30.8% of patients in 2014 to 12.5% in 2017. In multivariable analysis, older age, Middle Atlantic location, diabetes mellitus, insulin use, antiplatelet use, and more recent year were associated with lower likelihood of early repair; male sex, peripheral vascular disease, and the presence of extremity ischemia, rupture, shock, and acidosis were associated with higher likelihood of repair. Overall, repair of TBAD within 14 days of presentation declined from 2014 to 2017, with a steady rate of TEVAR but declining rate of open repairs. Further investigation into provider‐ and hospital‐specific factors as they relate to likelihood of repair is needed.
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影响因子：
4.3
作者：
Carroll, Brett J.;Schermerhorn, Marc;Secemsky, Eric A.
通讯作者：
Secemsky, Eric A.
DOI：
10.1161/circoutcomes.114.001140
发表时间：
2014-11
期刊：
Circulation. Cardiovascular quality and outcomes
影响因子：
--
作者：
Mody PS;Wang Y;Geirsson A;Kim N;Desai MM;Gupta A;Dodson JA;Krumholz HM
通讯作者：
Krumholz HM
影响因子：
24
作者：
Pape, Linda A.;Awais, Mazen;O'Gara, Patrick
通讯作者：
O'Gara, Patrick
影响因子：
4.3
作者：
Sachs, Teviah;Pomposelli, Frank;Schermerhorn, Marc
通讯作者：
Schermerhorn, Marc
影响因子：
4.3
作者：
Jones, Douglas W.;Goodney, Philip P.;Stone, David H.
通讯作者：
Stone, David H.