■关于室间隔完整治疗的大动脉转位后的长期死亡率和再干预的报告,虽然有利,主要限于单中心研究。对医院资源利用(住院天数)以及治疗选择和时机对结果的影响知之甚少。
■这项研究的目的是描述生存,全国数据集中动脉转换手术(ASO)后的再干预和医院资源利用。
■收集了2000年至2017年在英格兰和威尔士接受ASO的所有患者的随访和生活状态数据,并使用多变量回归和匹配进行了探索。
■总共确定了1,772名患者,ASO年龄中位数为9.5天(IQR:6.5-14.5天)。ASO后10年的死亡率和心脏再介入分别为3.2%(95%CI:2.5%-4.2%)和10.7%(95%CI:9.1%-12.2%),分别。ASO法术期间住院的中位时间为19天(IQR:14,24)。在ASO后的第一年,患者总共在医院度过了7天(IQR:4-10天),第五年后减少到1个门诊日/年。在具有完整风险因素数据的亚组(n=652)中,ASO年龄,和球囊房间隔造口术(BAS)的使用与晚期死亡率和再干预无关,但是心脏或先天性合并症,低重量,和ASO的循环/肾脏支持。匹配患者特征后,首先是BAS,然后是ASO和ASO,在生命的前三周内进行,有相当的早期和晚期结果,包括医院资源利用。
■死亡率和医院资源利用率较低,而再干预仍然相对频繁。早期ASO和BAS的个性化使用允许治疗选择的灵活性和对有风险患者的关注。
UNASSIGNED: Reports of long-term mortality and reintervention after transposition of the great arteries with intact ventricular septum treatment, although favorable, are mostly limited to single-center studies. Even less is known about hospital resource utilization (days at hospital) and the impact of treatment choices and timing on outcomes.
UNASSIGNED: The purpose of this study was to describe survival, reintervention and hospital resource utilization after arterial switch operation (ASO) in a national dataset.
UNASSIGNED: Follow-up and life status data for all patients undergoing ASO between 2000 and 2017 in England and Wales were collected and explored using multivariable regressions and matching.
UNASSIGNED: A total of 1,772 patients were identified, with median ASO age of 9.5 days (IQR: 6.5-14.5 days). Mortality and cardiac reintervention at 10 years after ASO were 3.2% (95% CI: 2.5%-4.2%) and 10.7% (95% CI: 9.1%-12.2%), respectively. The median time spent in hospital during the ASO spell was 19 days (IQR: 14, 24). Over the first year after the ASO patients spent 7 days (IQR: 4-10 days) in hospital in total, decreasing to 1 outpatient day/year beyond the fifth year. In a subgroup with complete risk factor data (n = 652), ASO age, and balloon atrial septostomy (BAS) use were not associated with late mortality and reintervention, but cardiac or congenital comorbidities, low weight, and circulatory/renal support at ASO were. After matching for patient characteristics, BAS followed by ASO and ASO as first procedure, performed within the first 3 weeks of life, had comparable early and late outcomes, including hospital resource utilization.
UNASSIGNED: Mortality and hospital resource utilization are low, while reintervention remains relatively frequent. Early ASO and individualized use of BAS allows for flexibility in treatment choices and a focus on at-risk patients.