PDF(Pubmed)
Abstract：
UNASSIGNED: Mechanical thrombectomy (MT) treatments for pulmonary embolism (PE) have yet to be compared directly. We aimed to determine if patient outcomes varied following treatment of PE with different MT devices.
UNASSIGNED: All PE encounters with an index treatment of MT between January 2018 and March 2022 were analyzed for in-hospital mortality, discharge to home, and 30-day readmission outcomes in the PINC AI™ Healthcare Database. MT devices used in each encounter were extracted from hospital charge description free-text fields using keyword text and fuzzy matching. Unadjusted and adjusted logistic regression was used to model outcomes by device.
UNASSIGNED: A total of 5893 encounters were identified using MT as the sole index PE treatment and 1812 using MT with another treatment. Of these, 41% had insufficient information to identify the devices used (unspecified MT), 33% used the FlowTriever System (large-bore volume-controlled aspiration MT), 23% the Indigo System (continuous aspiration MT), and 3% some other MT. Large-bore volume-controlled aspiration MT was used with other treatments 13% of the time compared with 23% and 39% for unspecified MT and continuous aspiration MT, respectively. Adjusted logistic regression modeling revealed the odds of in-hospital mortality were significantly higher for patients treated with unspecified MT ([OR] = 1.42, 95% confidence interval [CI]: [1.10-1.83], p = 0.008) or continuous aspiration MT (OR = 1.63, 95% CI: [1.21-2.19], p = 0.001) compared with large-bore volume-controlled aspiration MT. Discharge to home was significantly lower in these same groups (OR = 0.84, 95% CI: [0.73-0.96], p = 0.01, and OR = 0.63, 95% CI: [0.53-0.74], p < 0.001, respectively), but readmission risks at 30 days were comparable (OR = 1.08, 95% CI: [0.84-1.38], p = 0.56, and OR = 1.20, 95% CI: [0.89-1.62], p = 0.24, respectively).
UNASSIGNED: PE outcomes and treatment patterns differ significantly based on the type of MT utilized. Clinical studies directly comparing MT treatments are needed to further understand optimal treatment of PE.
UNASSIGNED: All PE encounters with an index treatment of MT between January 2018 and March 2022 were analyzed for in-hospital mortality, discharge to home, and 30-day readmission outcomes in the PINC AI™ Healthcare Database. MT devices used in each encounter were extracted from hospital charge description free-text fields using keyword text and fuzzy matching. Unadjusted and adjusted logistic regression was used to model outcomes by device.
UNASSIGNED: A total of 5893 encounters were identified using MT as the sole index PE treatment and 1812 using MT with another treatment. Of these, 41% had insufficient information to identify the devices used (unspecified MT), 33% used the FlowTriever System (large-bore volume-controlled aspiration MT), 23% the Indigo System (continuous aspiration MT), and 3% some other MT. Large-bore volume-controlled aspiration MT was used with other treatments 13% of the time compared with 23% and 39% for unspecified MT and continuous aspiration MT, respectively. Adjusted logistic regression modeling revealed the odds of in-hospital mortality were significantly higher for patients treated with unspecified MT ([OR] = 1.42, 95% confidence interval [CI]: [1.10-1.83], p = 0.008) or continuous aspiration MT (OR = 1.63, 95% CI: [1.21-2.19], p = 0.001) compared with large-bore volume-controlled aspiration MT. Discharge to home was significantly lower in these same groups (OR = 0.84, 95% CI: [0.73-0.96], p = 0.01, and OR = 0.63, 95% CI: [0.53-0.74], p < 0.001, respectively), but readmission risks at 30 days were comparable (OR = 1.08, 95% CI: [0.84-1.38], p = 0.56, and OR = 1.20, 95% CI: [0.89-1.62], p = 0.24, respectively).
UNASSIGNED: PE outcomes and treatment patterns differ significantly based on the type of MT utilized. Clinical studies directly comparing MT treatments are needed to further understand optimal treatment of PE.
摘要：
■肺栓塞（PE）的机械血栓切除术（MT）治疗方法尚未直接比较。我们旨在确定使用不同MT设备治疗PE后患者的预后是否有所不同。
在2018年1月至2022年3月期间，所有接受MT指数治疗的PE都被分析为住院死亡率。出院回家，以及PINCAI™医疗保健数据库中的30天再入院结果。使用关键字文本和模糊匹配从医院收费描述自由文本字段中提取每次相遇中使用的MT设备。未调整和调整的逻辑回归用于通过装置对结果进行建模。
■使用MT作为唯一指标PE治疗，总共发现了5893次相遇，使用MT与另一种治疗进行了1812次相遇。其中,41%的人没有足够的信息来识别所使用的设备(未指定MT)，33%使用FlowTriever系统(大口径容积控制抽吸MT),23%的靛蓝系统(连续抽吸MT)，和3%的其他MT。大口径容积控制抽吸MT与其他治疗一起使用13%的时间，而未指定MT和连续抽吸MT分别为23%和39%。分别。调整后的逻辑回归模型显示，接受未指定MT治疗的患者住院死亡率的几率明显更高（[OR]=1.42，95％置信区间[CI]：[1.10-1.83]，p=0.008)或连续抽吸MT(OR=1.63，95%CI：[1.21-2.19]，p=0.001）与大口径体积控制抽吸MT相比。在这些相同的组中，出院回家的人数显着降低（OR=0.84，95％CI：[0.73-0.96]，p=0.01，OR=0.63，95%CI：[0.53-0.74]，p分别<0.001)，但30天的再入院风险相当(OR=1.08，95%CI：[0.84-1.38]，p=0.56，OR=1.20，95%CI：[0.89-1.62]，分别为p=0.24)。
■根据所使用的MT类型，PE结果和治疗模式存在显着差异。需要直接比较MT治疗的临床研究，以进一步了解PE的最佳治疗方法。
在2018年1月至2022年3月期间，所有接受MT指数治疗的PE都被分析为住院死亡率。出院回家，以及PINCAI™医疗保健数据库中的30天再入院结果。使用关键字文本和模糊匹配从医院收费描述自由文本字段中提取每次相遇中使用的MT设备。未调整和调整的逻辑回归用于通过装置对结果进行建模。
■使用MT作为唯一指标PE治疗，总共发现了5893次相遇，使用MT与另一种治疗进行了1812次相遇。其中,41%的人没有足够的信息来识别所使用的设备(未指定MT)，33%使用FlowTriever系统(大口径容积控制抽吸MT),23%的靛蓝系统(连续抽吸MT)，和3%的其他MT。大口径容积控制抽吸MT与其他治疗一起使用13%的时间，而未指定MT和连续抽吸MT分别为23%和39%。分别。调整后的逻辑回归模型显示，接受未指定MT治疗的患者住院死亡率的几率明显更高（[OR]=1.42，95％置信区间[CI]：[1.10-1.83]，p=0.008)或连续抽吸MT(OR=1.63，95%CI：[1.21-2.19]，p=0.001）与大口径体积控制抽吸MT相比。在这些相同的组中，出院回家的人数显着降低（OR=0.84，95％CI：[0.73-0.96]，p=0.01，OR=0.63，95%CI：[0.53-0.74]，p分别<0.001)，但30天的再入院风险相当(OR=1.08，95%CI：[0.84-1.38]，p=0.56，OR=1.20，95%CI：[0.89-1.62]，分别为p=0.24)。
■根据所使用的MT类型，PE结果和治疗模式存在显着差异。需要直接比较MT治疗的临床研究，以进一步了解PE的最佳治疗方法。
