初级敷料对腿部静脉溃疡愈合的影响:一项来自医疗保险数据库的法国队列研究。

IF 1.5 4区 医学 Q3 DERMATOLOGY Journal of wound care Pub Date : 2024-09-02 DOI:10.12968/jowc.2024.0189
Sylvie Meaume, Patricia Senet, Benoît Thomé, Victor-Alexandre Aragno, Bohbot Serge, Sophie Fortin, Isabelle Boucley, Ulrique Michon-Pasturel, Hester Colboc
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引用次数: 0

摘要

目的:多组分绷带(MCB)被法国卫生局(Haute Autorité de Santé)推荐为静脉性腿部溃疡(VLU)的一线治疗方法。对法国行政医疗数据库(SNDS)中收集的 25,255 名静脉性腿部溃疡患者的数据进行的首次分析表明,考虑到愈合效果和伤口闭合的相关成本,MCB 相对于短弹力绷带更具优势。本研究旨在评估主要敷料(技术脂质胶体纳米寡糖因子(TLC NOSF)或对照敷料组(CDG))与 MCBs 结合使用治疗 VLU 时的益处:从 SNDS 收集符合以下纳入标准的患者数据:在整个治疗期间使用 MCBs 和相同类型的敷料(TLC-NOSF 或 CDG)治疗 VLU。痊愈结果记录在全球队列和倾向评分匹配队列中。计算了研究期内痊愈患者的平均医疗成本和对生态环境的影响:共有 12507 名患者符合 MCBs 和 TLC-NOSF 敷料(n=1134)与 MCBs 和 CDG(n=11373)的治疗标准;倾向得分匹配后,每组分别有 1134 名和 2268 名患者。在总体队列中,TLC-NOSF 组的愈合效果较好,在倾向得分匹配队列中,愈合效果也有所改善。在分析的每一点上,TLC-NOSF 组的调整后愈合率都明显高于 CDG 组(p 结论:这项 SNDS 分析证实,在 VLU 管理方面进行的最大规模的实际研究中,TLC-NOSF 敷料优于未浸渍 NOSF 化合物的敷料。MCB 和 TLC-NOSF 敷料的组合具有更好的临床效果、更低的成本和更积极的生态影响,应被视为全球治疗 VLU 的最佳标准。这些结果加强了目前国际指南中关于在这种病理情况下使用 NOSF 浸渍敷料(UrgoStart 系列;法国 Urgo 实验室)的立场。
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Impact of primary dressings on healing of venous leg ulcers: a French cohort study from the healthcare insurance database.

Objective: Multicomponent bandages (MCBs) are recommended by the French Authority for Health (Haute Autorité de Santé) as first-line treatment for venous leg ulcers (VLUs). A first analysis of the data collected from the French administrative healthcare database (Système National des Données de Santé (SNDS)) on 25,255 patients with a VLU supported superiority of MCBs versus short stretch bandages when considering the healing outcomes and costs associated with closure of these wounds. The aim of this study was to assess how beneficial the primary dressing (technology lipido-colloid nano-oligosaccharide factor (TLC NOSF) or control dressing group (CDG)) could be, when used in combination with MCBs in the treatment of VLUs.

Method: Data from the SNDS were collected for patients meeting the following inclusion criteria: treatment for a VLU with MCBs and with the same dressing type (TLC-NOSF or CDG) during the whole treatment period. Healing outcomes were documented on the global cohorts and propensity score-matched cohorts. The mean healthcare cost and the ecological impact were calculated for those patients healed within the study period.

Results: In total, 12,507 patients met the criteria for treatment with both MCBs and TLC-NOSF dressings (n=1134) versus MCBs and CDG (n=11,373); with 1134 and 2268 patients per group following propensity score matching. Healing outcomes were favourable for the TLC-NOSF group in the global cohort and were enhanced in the propensity score-matched cohorts. At every point of the analysis, the adjusted healing rates were significantly higher in the TLC-NOSF group than in the CDG group (p<0.001). In the propensity score-matched cohorts (n=3402), the healing rate at three months was 52% in the TLC-NOSF group versus 37% in the CDG group (p<0.001). The median healing time was 87 days versus 125.5 days in the TLC-NOSF and CDG groups, respectively (p<0.0001). TLC-NOSF dressings significantly reduced the average treatment cost per healed ulcer (€2099) by 23.7% compared with dressings without TLC-NOSF (€2751) (p<0.001), as well as the resources used.

Conclusion: This SNDS analysis confirms, in the largest real-life study performed in VLU management, the superiority of the TLC-NOSF dressings versus those not impregnated with the NOSF compound. Better clinical outcomes associated with cost savings and a positive ecological impact support the combination of MCBs and TLC-NOSF dressings and should be considered as an optimal standard of care for the global management of VLUs. These outcomes reinforce the current positions of the international guidelines on the use of NOSF impregnated dressings (UrgoStart range; Laboratoires Urgo, France) in this pathology.

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来源期刊
Journal of wound care
Journal of wound care DERMATOLOGY-
CiteScore
2.90
自引率
10.50%
发文量
215
期刊介绍: Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.
期刊最新文献
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