关于美国三尖瓣手术(TVS)的使用和结果的种族/族裔和性别差异的数据很少。作者旨在评估种族/民族和性别对TVS的利用和结果的影响。
■作者分析了2016年至2020年的全国住院患者样本数据库,以确定TVS的住院情况。使用逻辑回归模型确定TVS结果中的种族/种族和性别差异。
■在2016年至2020年之间,确定了19.395例TVS住院。在手术三尖瓣修复术(STVr)(331对493对634,P<0.01)和手术三尖瓣置换术(STVR)(312对601对728,P<0.01)中,黑人和西班牙裔患者的利用率(手术次数/100,000住院)低于白人患者。同样,与男性相比,女性的STVr(1021比1364,P<0.01)和STVR(930比1,316,P<0.01)的使用率较低。与接受TVS的白人相比,所有女性急性肾损伤的几率较低[校正比值比(aOR)0.65,95%CI0.55-0.78],输血的几率较高(aOR1.30,95%CI1.07-1.59),黑人男性输血的几率较高(aOR1.59,95%CI1.08-2.35)。各组间院内死亡率和其他手术并发症相似(均P>0.05)。
■在美国使用TVS时存在明显的种族/族裔和性别差异。需要进一步的研究来了解这些差异的原因,并确定缓解这些差异的有效策略。
UNASSIGNED: Data on racial/ethnic and sex disparities in the utilization and outcomes of tricuspid valve surgery (TVS) in the United States are scarce. The authors aimed to evaluate the impact of race/ethnicity and sex on the utilization and outcomes of TVS.
UNASSIGNED: The authors analyzed the National Inpatient Sample database from 2016 to 2020 to identify hospitalizations for TVS. Racial/ethnic and sex disparities in TVS outcomes were determined using logistic regression models.
UNASSIGNED: Between 2016 and 2020, 19 395 hospitalizations for TVS were identified. The utilization rate (number of surgeries/100,000 hospitalizations) was lower in Black and Hispanic patients compared with White patients for surgical tricuspid valve repair (STVr) (331 versus 493 versus 634, P<0.01) and surgical tricuspid valve replacement (STVR) (312 versus 601 versus 728, P<0.01). Similarly, the utilization rate was lower for women compared with men for STVr (1021 versus 1364, P<0.01) and STVR (930 versus 1,316, P<0.01). Compared to White men undergoing TVS, all women had lower odds of acute kidney injury [adjusted odds ratio (aOR) 0.65, 95% CI 0.55-0.78] and higher odds of blood transfusion (aOR 1.30, 95% CI 1.07-1.59), and Black men had higher odds of blood transfusion (aOR 1.59, 95% CI 1.08-2.35). In-hospital mortality and other surgical complications were similar between all groups (all P>0.05).
UNASSIGNED: Significant racial/ethnic and sex disparities exist in the utilization of TVS in the United States. Further studies are needed to understand the reasons for these disparities and to identify effective strategies for their mitigation.