PDF(Pubmed)
Abstract：
General anesthesia has traditionally been used in transcatheter aortic valve replacement; however, there has been increasing interest and momentum in alternative anesthetic techniques.
To perform a descriptive study of anesthetic management options in transcatheter aortic valve replacements in the United States, comparing trends in use of monitored anesthesia care versus general anesthesia.
Data evaluated from the American Society of Anesthesiologists\' (ASA) Anesthesia Quality Institute\'s National Anesthesia Clinical Outcomes Registry.
Multivariable logistic regression was used to identify predictors associated with use of monitored anesthesia care compared to general anesthesia.
The use of monitored anesthesia care has increased from 1.8% of cases in 2013 to 25.2% in 2017 (p = 0.0001). Patients were more likely ages 80+ (66% vs. 61%; p = 0.0001), male (54% vs. 52%; p = 0.0001), ASA physical status > III (86% vs. 80%; p = 0.0001), cared for in the Northeast (38% vs. 22%; p = 0.0001), and residents in zip codes with higher median income ($63,382 vs. $55,311; p = 0.0001). Multivariable analysis revealed each one-year increase in age, every 50 procedures performed annually at a practice, and being male were associated with 3% (p = 0.0001), 33% (p = 0.012), and 16% (p = 0.026) increased odds of monitored anesthesia care, respectively. Centers in the Northeast were more likely to use monitored anesthesia care (all p < 0.005). Patients who underwent approaches other than percutaneous femoral arterial were less likely to receive monitored anesthesia care (adjusted odds ratios all < 0.51; all p = 0.0001).
Anesthetic type for transcatheter aortic valve replacements in the United States varies with age, sex, geography, volume of cases performed at a center, and procedural approach.
To perform a descriptive study of anesthetic management options in transcatheter aortic valve replacements in the United States, comparing trends in use of monitored anesthesia care versus general anesthesia.
Data evaluated from the American Society of Anesthesiologists\' (ASA) Anesthesia Quality Institute\'s National Anesthesia Clinical Outcomes Registry.
Multivariable logistic regression was used to identify predictors associated with use of monitored anesthesia care compared to general anesthesia.
The use of monitored anesthesia care has increased from 1.8% of cases in 2013 to 25.2% in 2017 (p = 0.0001). Patients were more likely ages 80+ (66% vs. 61%; p = 0.0001), male (54% vs. 52%; p = 0.0001), ASA physical status > III (86% vs. 80%; p = 0.0001), cared for in the Northeast (38% vs. 22%; p = 0.0001), and residents in zip codes with higher median income ($63,382 vs. $55,311; p = 0.0001). Multivariable analysis revealed each one-year increase in age, every 50 procedures performed annually at a practice, and being male were associated with 3% (p = 0.0001), 33% (p = 0.012), and 16% (p = 0.026) increased odds of monitored anesthesia care, respectively. Centers in the Northeast were more likely to use monitored anesthesia care (all p < 0.005). Patients who underwent approaches other than percutaneous femoral arterial were less likely to receive monitored anesthesia care (adjusted odds ratios all < 0.51; all p = 0.0001).
Anesthetic type for transcatheter aortic valve replacements in the United States varies with age, sex, geography, volume of cases performed at a center, and procedural approach.
摘要：
UNASSIGNED：全身麻醉传统上用于经导管主动脉瓣置换术；然而，人们对替代麻醉技术的兴趣和势头越来越大。
UNASSIGNED：为了对美国经导管主动脉瓣置换术中的麻醉管理选择进行描述性研究，比较监测麻醉护理与全身麻醉的使用趋势。
UNASSIGNED：数据来自美国麻醉医师协会（ASA）麻醉质量研究所的国家麻醉临床结果注册。
UNASSIGNED：使用多变量逻辑回归来确定与全身麻醉相比使用监测麻醉护理相关的预测因素。
UNASSIGNED：监测麻醉护理的使用已从2013年的1.8％增加到2017年的25.2％（p=0.0001）。患者年龄在80岁以上（66％vs.61%；p=0.0001），男性(54%vs.52%；p=0.0001），ASA身体状况>III（86%vs.80%；p=0.0001），在东北部得到照顾(38%与22%；p=0.0001），和邮政编码中值收入较高的居民(63,382美元与55,311美元；p=0.0001）。多变量分析显示，年龄每增加一年，每年在一次实践中执行的每50个程序，男性与3%相关(p=0.0001)，33%（p=0.012），和16％（p=0.026）增加监测麻醉护理的几率，分别。东北地区的中心更有可能使用监测麻醉护理（所有p<0.005）。除了经皮股动脉以外，接受其他方法的患者不太可能接受监测的麻醉护理（调整后的比值比均<0.51；均p=0.0001）。
UNASSIGNED：美国经导管主动脉瓣置换术的麻醉类型随年龄而变化，性别,地理,在中心执行的案件量，和程序方法。
UNASSIGNED：为了对美国经导管主动脉瓣置换术中的麻醉管理选择进行描述性研究，比较监测麻醉护理与全身麻醉的使用趋势。
UNASSIGNED：数据来自美国麻醉医师协会（ASA）麻醉质量研究所的国家麻醉临床结果注册。
UNASSIGNED：使用多变量逻辑回归来确定与全身麻醉相比使用监测麻醉护理相关的预测因素。
UNASSIGNED：监测麻醉护理的使用已从2013年的1.8％增加到2017年的25.2％（p=0.0001）。患者年龄在80岁以上（66％vs.61%；p=0.0001），男性(54%vs.52%；p=0.0001），ASA身体状况>III（86%vs.80%；p=0.0001），在东北部得到照顾(38%与22%；p=0.0001），和邮政编码中值收入较高的居民(63,382美元与55,311美元；p=0.0001）。多变量分析显示，年龄每增加一年，每年在一次实践中执行的每50个程序，男性与3%相关(p=0.0001)，33%（p=0.012），和16％（p=0.026）增加监测麻醉护理的几率，分别。东北地区的中心更有可能使用监测麻醉护理（所有p<0.005）。除了经皮股动脉以外，接受其他方法的患者不太可能接受监测的麻醉护理（调整后的比值比均<0.51；均p=0.0001）。
UNASSIGNED：美国经导管主动脉瓣置换术的麻醉类型随年龄而变化，性别,地理,在中心执行的案件量，和程序方法。
