Justin M Lapow, Rajkumar S Pammal, Martina Brozynski, Samantha Sudol, Smit D Patel, Eric Feldstein, Bridget E Nolan, Kevin M Clare, Steven Shapiro, Haris Kamal, Krishna Amuluru, William Frishman, Srihari Naidu, Howard Cooper, Chirag D Gandhi, Fawaz Al-Mufti
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引用次数: 0
摘要
导管血管造影术是诊断和治疗患者血管并发症的重要程序。由于脑血管造影术和冠状动脉造影术是类似的技术,使用相同的入路部位和一般原理,因此相关的风险是重叠的,应加以识别,以帮助指导患者护理。本研究旨在确定脑血管造影和冠状动脉造影患者的并发症发生率,并对冠状动脉造影和脑血管造影并发症进行比较分析。研究人员查询了 2008 年至 2014 年的全国住院患者样本,以确定接受冠状动脉或脑血管造影术的患者。在对合并队列的基线特征、并发症发生率和处置情况进行评估后,根据人口统计学和合并症,利用倾向匹配建立了冠状动脉和脑血管造影术患者子队列。然后对手术并发症和处置进行比较分析。我们的研究队列共纳入了 3,763,651 例住院患者(3,505,715 例冠状动脉血管造影术患者和 257,936 例脑血管造影术患者)。中位年龄为 62.9 岁,女性占 46.42%。总体队列中最常见的合并症是高血压(69.92%)、冠心病(69.48%)、吸烟(35.64%)和糖尿病(35.13%)。倾向匹配显示,脑血管造影队列中急性和不明原因肾衰竭(5.4% vs 9.2%,OR 0.57,95% CI,0.53-0.61,P <0.001)、出血/血肿形成(0.8% vs 1.3%,OR 0.63,95% CI,0.54-0.73,P <0.001),腹膜后血肿形成率(0.03% vs 0.04%,OR 1.49,95% CI,0.76-2.90,P =0.247)和动脉栓塞/血栓形成率(0.3% vs 0.3%,OR 1.01,95% CI,0.81-1.27,P =0.900)相当。我们的研究表明,脑血管造影和冠状动脉造影的手术并发症发生率普遍较低。匹配队列分析表明,脑血管造影术患者发生并发症的风险并不比冠状动脉造影术患者高。
Complication Rates Following Cerebral and Coronary Angiography: Nationwide Analysis 2008-2014.
Catheter-based angiography is an essential procedure for the diagnosis and treatment of vascular complications in patients. Since cerebral and coronary angiography are similar techniques that utilize the same access sites and general principles, the associated risks overlap and should be identified to help direct patient care. The purpose of this study was to determine complication rates in a combined cohort of cerebral and coronary angiography patients, as well as conduct a comparative analysis of coronary and cerebral angiography complications. The National Inpatient Sample was queried from 2008 to 2014 to identify patients who underwent coronary or cerebral angiography. After assessment of baseline characteristics, complication rates, and disposition in the combined cohort, propensity matching was utilized to create sub-cohorts of coronary and cerebral angiography patients based on demographics and comorbidities. Comparative analysis of procedural complications and disposition was then performed. A total of 3,763,651 hospitalizations were included in our study cohort (3,505,715 coronary angiographies and 257,936 cerebral angiographies). The median age was 62.9 years, with females being 46.42%. The most prevalent comorbidities in the overall cohort were hypertension (69.92%), coronary artery disease (69.48%), smoking (35.64%), and diabetes mellitus (35.13%). Propensity matching demonstrated that the cerebral angiography cohort had lower rates of acute and unspecified renal failure (5.4% vs 9.2%, OR 0.57, 95% CI, 0.53-0.61, P < 0.001), hemorrhage/hematoma formation (0.8% vs 1.3%, OR 0.63, 95% CI, 0.54-0.73, P < 0.001), and equivalent rates of retroperitoneum hematoma formation (0.03% vs 0.04%, OR 1.49, 95% CI, 0.76-2.90, P = 0.247) and arterial embolism/thrombus formation (0.3% vs 0.3%, OR 1.01, 95% CI, 0.81-1.27, P = 0.900). Our study showed both cerebral and coronary angiography have generally low rates of procedural complications. Matched cohort analysis demonstrated that cerebral angiography patients are at no greater risk for complications than coronary angiography patients.
期刊介绍:
The mission of Cardiology in Review is to publish reviews on topics of current interest in cardiology that will foster increased understanding of the pathogenesis, diagnosis, clinical course, prevention, and treatment of cardiovascular disorders. Articles of the highest quality are written by authorities in the field and published promptly in a readable format with visual appeal